ML20198H724

Forwards Corrected Pages to Stier Rept of Investigation TMI-2 Leak Rate Testing & Stier

ML20198H724
Person / Time
Site:	Three Mile Island
Issue date:	01/24/1986
From:	Phyllis Clark GENERAL PUBLIC UTILITIES CORP.
To:	Harold Denton Office of Nuclear Reactor Regulation
References
4410-86-L-0023, 4410-86-L-23, NUDOCS 8601310082
Download: ML20198H724 (136)

Text

i GPU Nuclear ggIg[ 100 Interpace Parkway Parsippany. New Jersey 07054 201 263-6500 TELEX 136-482 Wnter's Direct Dial Number:

January 24, 1986 (201) 263-6797 4410-86-L-0023 Mr. Harold R. Denton, Director Office of Nuclear Reactor Regulation United States Nuclear Regulatory Comissiori Washington, DC 20555

SUBJECT:

THREE MILE ISLAND UNIT N0. 2 STIER REPORT /TM1-2 LEAK RATE TESTING DOCKET NO. 50-4M 520 My letter dated September 9,1985 fonearded copies of the report by Mr. Stier of his investigation of TMI-2 Leak Rate Testing. M r. Stier has now provided us with corrected pages for a number of errors he found in the report.

Enclosed is a copy of the corrected pages together with a copy of Mr. Stier's January 17, 1986 cover letter.

r Sincerely ,

17 f P. R. Clark President pfk Enclosures AD . D. CRCTCHFitLD (ltr only)

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• 8601310082 G60124 PDR ADOCK 05000320 p PDR GPU Nuclear is a part of the General Pub lic Utihties Sys'em l

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EDWIN H. STIER, PA ATTORNEY AT LAW I I E. CLirr STREET TELEpwCNE 50MERvlLLE. NEW.;ERSEY 08876 (201)725 4111 January 17, 1986 Mr. Philip R. Clark President GPU Nuclear Corporation 100 Interpace Parkway Parsippany, N. J. 07054 Re: TMI-2 Reactor Coolant Inventory Balance Testing Report

Dear Mr. Clark:

Since we filed our report with you, we have fdund a number of minor errors that should be corrected. None of those errors affects the substance of the report or in any way alters our conclusions.

I have prepared corrected pages that can easily be inserted into the report. On each new page, the binding holes have been slit so that the page can be attached to the binder in its proper sequence without removing any other pages.

The lines on which changes have been,made are indicated by a bar in the right hand margin of the page. Each page also bears the date of the corrections so that it can be distinguished from the original pages in the report.

The substitute pages have been organized by volume number.

A cover page for each volume contains a list of the new pages to be included in that volume and any necessary instructions.

Very truly yours,

'W __

Edwin H. Stier EHS:cr

VOLUME I REPLACEMENT PAGES:

24, 28, 29, 34, 47, 50, 54, 58, 68, 74, 76, 77, 79, 84, 92, 93, 94, 118, 123, 135, 139, 147, 148, 151, 155, 159, 160, 161, 162, 167, 168 l

i 1

3 L

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• Operations Department l personnel did not avoid performina leak rate tests when plant conditions would be likely to increase the chances of obtaining unreliable test results.

1 The majority of filed leak rate test results were

. influenced by: rerunning tests until a satis-f factory result (test result under 1.0 apm) was obtained; runnina tests with faulty instrumentation or with other sources of unreliable data; or ma nipu la tina the data so as to increase the probability of achieving a satisfactory re su lt .

i The primary methods of ma nipu la tino data involved addina hydrogen or water to the makeup tank durina a test. The most consistently successful metnod was to add water to the makeup tank and to accou n t for the addition in the test calculation. Makeup tank level instrument inaccuracy, in combination with a calcu la tion error in the test procedure, wou ld influence the test result in favor of a lower unidentified leak rate.

24 - [c rrected 1/17/86]

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NOTES INTRODUCTION 1 Hartman, 3/24/80.

2 Faeore & Benson, 2300 Multifoods Tower, 33 South Sixth Street, Minneapolis, MN 55402.

3 The Faegre & Benson Report (September 17, 1980) has not been included as an exhibit to this report. The interview of Hartman, however, has been included amona I

the witness statements contained in Volume VI of this report.

4 The NRC Region I Report of June 3, 1983, has not been included as an exhibit to this report. The statements attached to that report, however, have been included among the witness statements contained in Volume VI of this report.

( 5 Memorandum, Ben B. Hayes to NRC Commissioners, Three Mile Island Nuclear Generatina Station Unit 2/ Alleged

Falsification of L,cck Rate Surveillance Test Data (1-83-010), August 15, 1984. This memorandum and its j accompanyina report have not been included as exhibits to thi's report.

6 Statement of Facts submitted by the United States, (United States of America v. Metropolitan Edison Company), February 1984, (Tab 2);

Statement of Metropolitan Edison Company With Respect to Plea Aareement, (United States of America v. Metropolitan Edison Company, February, 1984, (Tab 3).

7 U.S. Nuclear Regulatory Commission, NUREG-0680, TMI-l Restart, Supplement No. 5, July, 1984. This document has not been included as an exhibit to this report.

8 Hayes Memo, p. 1.

9 Ibid.;

NUREG-0680, Supp. No. 5, pp. 5-5, 5-6.

10 Metropolitan Edison Statement, p. 9, (Tab 3).

[ corrected 1/17/86]

l _ _ _ _ _ _ _ _ _ . -

i 11 Letter, P. R. Clark to E. H. Stier, February 1, 1984, (Tab 1) .

12 Edwin H. Stier: Graduated from Rutgers University (AB) 1961 and Rutgers Law School (LLB) 1964; Member of the NJ Bar; October 1, 1982 to October 1, 1984 - member of the firm of Kirsten, Friedman, and Cherin, Newark NJ; 1977 to 1982 - Director, New Jersey Division of Criminal Justice (Assistant Attorney General); 1969 to 1977 - held the positions of Deputy Attorney General in charae, Oroanized Crime and Special Prosecution Section; Assistant to the Director; and Deputy Director in the New Jersey Division of Criminal Justice; 1967 to 1969 - Chief of the Criminal 4

Division, Office of the United States Attorney, District of New Jersey.

1965 to 1967 - Assistant U.S. Attorney, District of New Jersey; 1964 to 1965 - Law Clerk to the Honorable Au thur W. Lewis, Judge of the Appellate l

Division, Superior Court of New Jersey. ,.

13 Frederick P. DeVesa: Graduated f rom Rutaers University (BA) 1969 and Seton Hall University, School of Law (JD com laude) 1975; member of the NJ Bar; March 1, 1984 to October 1, 1984 - member of the firm of Kirsten, Friedman, and Cherin; 1979 - 1984 - Assistant Attorney General and Deputy Director, New Jersey Division of Criminal Justice; 1975 to 1979 - Assistant Director for Special Projects; and Deputy Attorney General, Economic Crime Section, New Jersey Division of Criminal Justice; 1975 to 1979 - Assistant Passaic County Prosecutor; 1968 to 1975 - Police Officer and Detective, Newark, New Jersey Police Departnent.

Robert T. Winter: Graduated from Villanova University (BS) 1965 and Catholic University Law School (JD) 1968; Member of the NJ and NY Bar; March 1, 1984 to October 1, 1984 - member of the firm of Kirsten, Friedman, and Cherin; 1982 to 1984 - Rackets Bureau Chief, Brooklyn District Attorney's Office, New York City: 1978 - 1982 -

Assistant Attorney General and Deputy Director for Investigations of the New Jersey Division of Criminal Ju stice ; 1972 to 1978 - Deputy Attorney General - Bureau Chief of State Enforcement Bu reau ; 1970 to 1972 -

Associate with the firm of Drazin, Warshaw, Auerbach and Rudnick; 1969 to 1970 - Depu ty Pu blic Def ender, Essex County New Jersey; 1968 to 1969 - Law Clerk to the Honorable Joseph G. Lyons, Judae of the Law Division, Superior Court of New Jersey.

[ corrected 1/17/86]

\ _____ _ ___ __.

The Reg. Guide stresses that identified leakage should be quantified, stating " leakage to the primary containment from identified sources should be collected or otherwise isolated so that (a) the flow rates are monitored separately from unidenti- l fied leakage and (b) the total flow rate can be established and monitored."

Reg. Guide 1.45 suggests a specific limit on unidentified leakage and the reasons for that limit stating, "A small amount of unidentified leakage may be impracti cal to eliminate, but it should be reduced to a small flow rate, preferably less than one gallon per minute (gpm) to permit the leakage detection systems to detect positively and rapidly a small increase in flow rate. Thus, a small unidentified leakage rate that is of concern will not be masked by a larger acceptable identi fied leakage rate." The standard of 1.0 gpm appears to be based on a judgment that " industry practice" demonstrates that a flow rate change from 0.5 to 1.0 gpm can be detected.

The Reg. Guide provides some flexibility to licensees in designing leakage detection systems. Redundancy among such systems and early alarms " signaling the operators that closer examination of other detection systems is necessary" are speci-fied as requirements.10 Additionally, each detection system (corrected 1/17/86]

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, details, general patterns of behavior can be reconstructed from the evidence.

These practices will be the primary focus of the remainder of this report. However, because the Operations Department administered the test, we will briefly discuss the organization within that department and the division of leak rate testing responsibilities among its members.

Operations Department Organization The Operations Department at each Unit was headed by a Supervisor of Operations. His duties, in addition to the over-all administration of his department, incl uded a specific duty to " ensure compliance with the Technical Specifications."

The working day was divided into three shifts, 7am-3pm, 3pm-11pm, and llpm-7am. Each shift was headed by a Shift Supervisor who was responsible for overseeing Operations Department activities at both Units. Therefore, he would divide his time between TMI-1 and TMI-2 during his shift. The Shift Supervisor had a general duty to oversee the performance of surveillance tests on his shift. He was specifically re-quired to review and initial any Exception or Deficiency that resulted from surveillance test performance on his shift and to evaluate the safety implications of identified leakage.55

[ Corrected 1/17/86]

~

DUTY TO DOCUMENT LEAKAGE BY MEANS OF THE LEAK RATE TEST The Technical Specifications and procedures in effect at TMI-2 created a procedural scheme in which Operations Depart-ment personnel had two related but distinct sets of duties.

First, they were requ ired to docu ment reactor coolant system

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leakage by means of the leak rate test. Second, they were requ ired to take specified action when leakace exceeded a limitina condition for operation. Our analysis of the evidence will be separated accordina to these duties. We first deal with the requirement that leakaae be documented by means of the leak rate test. The duty to act in response to indications of excessive leakage will be discussed later in this report.

The basic elements of the procedural. scheme at TMI-2 con-trollina the documentation of reactor coolant system leakaoe are as follows:

• A leak rate test was to be performed at least once every 72 hours8.333333e-4 days <br />0.02 hours <br />1.190476e-4 weeks <br />2.7396e-5 months <br /> when the plant was in modes 1 throu ch 4 and operating under steady state conditions.

• The pu rpose of the test was to quantify and record the rates of identified and unidentified reactor coolant system leakage.

[ corrected 1/17/85]

An examination of the 222 documented tests shows that 31 water l l

additions were made while tests were in progress. All bu t seven of them were included in the calculation. Of these seven, three were documented in the Control Room Loa bu t were l

not accounted for in the calculation. Only f ou r were neither documented in the Control Room Loa nor accou nted for in the calculation.72 After the CRO entered the required data, the compu ter wou ld complete the test calculation and print ou t the r esu lt . If the unidentified leakaae stated on the compu te r pr intou t was below 1.0 qpm, the CRO performing the test would sign the test sheet and su bmit it to the Shift Foreman. The Foreman would review the resu lt to determine that leakage did not exceed limitino conditions for operation. If he were satisfied, he wou ld 3

approve the test and sian the test sheet.

A loa entry would then be made, indicatina that a test had been performed. This practice appears to have been somewhat erratic. Of the 222 documented tests on file, 52 tests were not loaged at all. Eight of those did not bear the siona tu r e of a test performer or approver. Ninety-four tests were recorded in the Control Room Log. Even thou a h the Shift Foreman was not required to make an entry in his 100 concernina leak rate tests, 168 tests were loaged by Shift Foremen.

I (corrected 1/17/86)

unreliable data; or manipulating the data so as to l increase the probability of achieving a satis-f actory result.

The primary methods of manipulatina data involved adding hydrogen or water to the makeup tank during a test. The most consistently successful method was to add water to the makeup tank and to accou nt for the addition in the test calculation. Makeup tank level instrument inaccu racy, in combination with a calculation error in the test procedure, wou ld influence the test result in favor of a lower unidentified leak rate.

Discardino Leak Rate Test Results The most prevalent practice evidencina the f ailu re of TMI-2 personnel to use the leak rate test to document reactor coolant system leakage was the discarding of all test results exceedina 1.0 gpm of unidentified leakage. Tne practice of discarding test resu lts that were unsatisfactory began at TMI-l early in its operation, in September 1974.80 The Supervisor of Operations at TMI-2 had pr eviou sly held the same position at f TMI-1. Under his supervision, a similar policy of discardina unsatisfactory test resu lts was established at TMI-2 even before leak rate testina began at that plant in March 1978.

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[ corrected 1/17/86)

- the personnel administering these tests. We determined that numerous tests were conducted during non-steady state conditions when test results would obviously be affected. In

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addition, test results that should have been highly suspect to operators and Shift Foremen, based on their review of the test sheets, were nevertheless filed.

During this period, 43 tests were filed. Nineteen (44 percent) of these tests were performed in violation of leak rate test procedures relating to required plant conditions or were otherwise obviously invalid.

Six of the 19 tests were performed at times when reactor coolant system temperature was under 200*F and the plant was in Mode 5. Therefore, no leak rate testing was required.

The computer's temperature measurement l'.. trumenta tion was not calibrated to measure temperatures u,ier 520*F. When a test calculation was performed by the ccmputer under those conditions, the computer would print the temperature in dollar signs ($$), indicating that the temperature had not been accurately read. All six of these tests contained temperatures printed in dollar signs. They were

[ corrected 1/17/86]

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was switched to the computer and a leak rate test was per-formed.I The test result was filed, even though it was ,

i recognized on that shift that the level transmitter providing data to the computer was not operating properly.

l Between December 5, 1978, and January 10, 1979, 46 tests were filed. Twenty-eight of those tests were performed using l the inaccurate makeup tank level transmitter.

Fxamination of the 17 tests that were performed on the

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properly functioning level transmitter shows further evidence of an awareness by operators that one transmitter was in-accurate. In 11 instances, the operators kept the reliable transmitter connected to the strip chart where it could be used to monitor makeup tank level changes until a leak rate test was about to be performed.II At that point, the reliable trans-mitter was switched to the computer for the performance of the test. When the test was completed, it would then be returned to the strip chart.

An example of a makeup tank strip chart that shows the reliable transmitter being switched to the computer for the performance of a leak rate test, is shown in Figure 2 (on the following page). 1 The trace on this strip chart appears normal until the beginning of the test when it begins to

[ corrected 1/17/86)

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were being performed with that instrument, bu t probably yielded l results that were discarded.

It is possible that certain operators recognized the potential for obtainino satisfactory test results by usina the l

inaccurate level transmitter. It should be noted that Hartman described a practice of switching level transmitters to achieve satisfactory results. Although he might have been referrina to the use of the inaccurate level transmitter durina this period, he had no personal knowledge of this method havina been used.122 In our view, there is insu f ficient evidence to su ppor t a ceneral findino that the faulty level transmitter was system-atically selected by Operations Department personnel to improve the chance of obtaining a satisfactory r e su lt . It is clear, l

however, tnat tests were regularly performed usino this unreli-able sou rce of data, and that these tests were repeatedly filed even though they should have been invalidated as a result of that data.123 The effects of the f au lty transmitter on leak rate tests were, at best, disregarded by Operations personnel.

Ja nu a ry 10 - Ja nu a ry 15, 1979 MPR's analysis shows that unidentified leakage remained over 1.0 apm throuah January 15, 1979. Since the malfu nct ion-I'

• k f f ailu re to accou nt for them in the tests was not acciden-  ;

tal.1 Four of the seven water additions were not recorded in any log. The remaining three were recorded in the Control r Room Loo.1 6 The testimony su ccests that such water additions cou ld have occurred through inadvertence rather than l with the intent to manipulate test results.137 The most su spiciou s tests that were influ enced by unac-counted-for water additions occurred on January 13 and February 23.138 Both tests were performed by Hartman and the water addition made during each test was recorded in the Control Room Log. In each case, a long period had elapsed since a leak rate test had been filed. Four shifts had been u nsu ccessfu l in obtaining a satisfactory leak rate test prior to the January 13 l test and five shifts had failed to file a test prior to the February 23 test.

Our conclusion concerning the January 13 test (d iscu ssed earlier in this report) was that Hartman's statement that he could not recall ever using this method to manipulate tests lef t us with some uncertainty that the January test resu lt was intentionally influenced by the unaccounted-for water addition.

The same conclusion applies to the February 23 test.

[ corrected 1/17/86]

s Because of this error, the calculated unidentified leak rate I was overstated by an amount equ al to 40 percent of the reactor coolant drain tank collection rate . For that reason, when

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reactor coolant drain tank collection reached a rate of 2.5 gpm at room tempera tu re , the unidentified leak rate calcu la ted at reactor coolant system tempe ra tu re would be greater than the l actu al unidentified leakage by 1.0 gpm, even if the actual l l

unidentified leak rate had not changed.

This rate of drain tank collection (2.5 gpm) was reached around Febru a ry 25. Of course, if there were any ac tu al unidentified leakage, the calcu la ted unidentified leak rate would have exceeded 1.0 opm sometime before that date.

Hydrocen Additions Witnesses stated that during the period of hiah reactor coolant drain tank collection (mid-February through March l 1979), they experienced difficulty in obtaining leak rate test results under 1.0 apm.152 Although we cannot fix the time by direct evidence, members of the Operations Department discussed among themselves their observation that hydrocen, when added to the makeup tank during a leak rate test, wou ld increase the chance of obtaining a test resu lt under 1.0 qpm. Some experimentation was performed in order to confirm tnis phenomenon. The CRO's who most freely admitted knowing the

effect of hydroaen on leak rate tests testified that they learned of it from other CRO's during informal discussions.153 l Circumstantial evidence tends to show that these discu ssions and experiments took place during February and March 1979, the period when MPR has determined that the makeup tank level instrumentation was responsive to ma keu p tank pressure chances.

l Hartman associated hydroaen additions as a means of manipu la ting tests with the period when pr es su r ize r relief valve leakage was high.1S4 This would have been in February l and March 1979.

Two experiments can be documented as having occurred in February. On February 15, a notation was made on the makeup tank strip chart that hydrogen was added. An arrow drawn on the strip chart points to a slight rise in the trace sugaestinq that it was cau seri by the hydrogen pressure increase.155 Fiqure 3 (on the followina page) shows that the strip chart trace and the rise in the trace can be plainly seen.

That hydrocen addition corresponds to an entry in the Control Room Loa.156 The CRO who conducted the experiment to

[c rrected 1/17/86]

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"[Approximately) 2.0 gpm leakage indicated on Makeup Tank level. Since no other leakage is existing the RC-V-133B, 134B, and 135B leakage is identified and below [ illegible]."210 Through interviews, we have found that both Notes were

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written by the same individual, the Superintendent -

Technical Support. He tes ti fi ed that he cannot recall the events surrounding the Notes. Powever, he does not believe the method used for quantifying the leakage that is described in the 17ote was adequate to categorize the leakage as " identified leakage" within the meaning of the Technical Speci fi ca t i ons and the leak rate test procedure.

We agree with him that the efforta made on January 13 to quantify ldakage were inadequate to satisfy Technical Specification requirements. Technical Specifications require that identified leakage should not interfere with unidenti fied leakage detection. The history of the Technical Specification definition of " unidentified leakage" discussed earlier in this report makes it clear that it must be measured in some way that assures that other leakage will not remain undetected. The deductive approach taken in the Operations Memo of January 13 does not meet that standard. It could not assure that an undetected pipe flaw or some other unidentified leakage was not

- 118 - [ corrected 1/17/86)

The practices of manipulating tests developed among CRO's as a response to instructions from Operations  ;

Department supervisors to obtain unidentified leak-age results under 1.0 gpm.

The evidence does not establish that management personnel above the level of the Operations Depart-ment participated in or consciously tolerated im-proper leak rate test practices, l

• TMI-2 management became aware that Operations l Department personnel were not meeting Technical l

Specification requirements for action in response to excessive leak rate test results. The notifi-cation forwarded by TMI-2 management to their superiors and to the NRC did not correctly identify the source of the problem, and the remedial action taken by TMI-2 management was ineffective.

Operations Department Management The practice of discarding any test results showing unidentified leakage over 1.0 gpm and filing any results under that limit was established at TMI-2 from the beginning of its l operation. No one could describe the precise origin of

- 123 - [ corrected 1/17/86]

the U.S. Attorney felt some uncertainty about who participated in that converstaion. The statement says, "The call was made i

l to either TMI's Station Superintendent or Metropolitan Edi son 's Vice President for Generation or both."

l We have not been able to confirm that telephone call. Both the Station Superintendent and the Vice President for Genera-6 tion deny knowledge of the conversation. None of the other witnesses we interviewed recall participating in, or being aware of, such a conversation. Even if we assume that the conversation took place as described by the U.S. Attorney, its content would have alerted upper management only to the difficulty of obtaining satisfactory results. The statement does not allege that the practices of discarding and filing tests without proper evaluation, exploiting unreliable data and manipulating tests were discussed.

By their very nature, the practices of discarding tests and failing to follow procedures for documenting test results tended to conceal such conduct. Although the CRO's openly followed these practices and discussed their problems in performing leak rate tests, the evidence does not show that anyone outside the Operations Department observed their conduct or participated in their discussions.

135 - [ corrected 1/17/86]

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i procedures. It was filed on January 24, 1979. That report l does not discuss the performance of leak rate tests. The explanation offered by the auditor was that he believed the

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plant had begun commercial opera tion too recently to collect sufficient data on test performance. Therefore, he did not investigate the extent to which test practices conformed to Technical Specifications and procedural requirements.

In the one instance that improper test practices came to the attention of upper management, the improper conduct was not tolerated, but the corrective action taken by TMI-2 management was ineffective in assuring that Technical Specification requirements were met. These events occurred in mid-October, 197P and have been discussed previously in this report.

Although the actions taken by management during this period were inadequate to correct the behavior of Opera tion s Personnel, the evidence does not show that this result was intended by anyone in upper management.

On the morning of October 18, 1978, the NRC Inspector, conducting a periodic inspection, entered the TMI-2 control room and interrupted a conversation among a group of TMI-2 supervisors concerning unsatisfactory leak rate tests. During the conversation, the Supervisor of Operations joined the group. The inspector observed several test sheets from the two

- 139 - [ corrected 1/17/86)

_ _ _ _ _ _ _ _ _ ~ _ _ - - - --

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21 Tech Specs, Section 4.4.6.2, (Tab 14).

L 22 Ibid., Sections 1.14 through 1.17., (Tab 14);

Vol. IV (MPR Report), Appendix B.

23 Tech Specs, Section 6.9.1.8, (Tab 14).

24 Tech Specs, Section 6.10.1d, (Tab 14).

25 TMI-2 Final Safety Anal.ysis Report, Supplement 3, Amendments 28 & 33, (Tab 15).

26 Frederick 3/12/85, pp. 2, 45-50; Adams 3/8/85, pp. 76-77; Smith 2/8/85, p. 17; Congdon 2/13/85, pp. 37-38; Mehler 2/28/85, p. 45; Guthrie 2/12/85, p. 5; McGovern 2/6/85, p. 14; Faust 2/20/85, p. 25.

27 TMI-2 Surveillance Procedure 2301-3Dl, RCS Inventory, Rev. 2, May 4, 1978, Section 1.0, (Tab 19);

This portion of our report does not discuss the details of the leak rate test calculation. For a description and an analysis of the leak rate calculation see Volume IV (MPR Report), Appendix A.

28 Tech Specs, Table 1.1, (Tab 14).

29 SP 2301-3DJ, Section 3.0, (Tab 19).

30 Ibid., Section 6.3, (Tab 19).

31 Ibid., Section 3.2 and 3.3, (Tab 19).

32 Ibid., Section 3.4, (Tab 19).

33 Revision 3 of SP 2301-3Dl, Section 4.3, effective 2/5/79 was the first revision to specifically warn against using the computer when RCS temperature was below 520*F.

34 sp 2301-3Dl, Section 6.3, (Tab 19). l 35 Ibid., Section 6.4.1, (Tab 19).

- 147 -

[ corrected 1/17/86]

i _ _ _ _ _ _ _

36 SP 233.1-301, Section 6.4.2, (Tab 19); j l

It should be noted that 'che computer test data sheet does not contain x Femark c " section. Such a section only appears on the manual calculation sheet. A s similar defede appeared in the 7MI-l procedure. See TMI-l Reactor ecolant Inventory Balance Testing,

< June TS, 1984, pp.Ul-84.

~

37 SP 2301-3Dl, Cection 6,4.3, (Tcb 19).

38 Ibid _., Section 6.4.4, (Tab 17).

39 Ibid., Section 5.4.4, (Tab 19).

40 Ibid., Section 7, (Tab 19).

41 TMI Station Administrative Procedure 1012, Shift Pelief and Loc Entries, Rev. 8, November 4, 1977 Secticri  ;

3.3.17 and Section 3.4.3, (Tab 101 42 Ibid., Section 2.2, (Tab 18).

43 TMI Station Administrative Procedure 1016, Techrfcal Specification Surveillance Program, Pev, lj, Jancory 9, 1979, Section 3.2.4, (Tab 17). ~

44 Ibid., Section 3.2.4.1, (Tab 17).

45 Ibid., Section 3.2.4.2, (Tab 17).

46 Ibid., Section 3.2.4, (Tab 17).

47 Ibid., Section 3.2.4.2, (Tab 17).

48 Ibid., Section 3.2.4, (Tab 17).

49 Ibid., Section 3.2.3, (Tab 17).

50 Ibid., Section 2.3, (Tab 17).

51 Ibid., Section 2.3, (Tab 17).

52 Ibid., Section 2.4, (Tab 17).

- 148 - (corrected 1/17/86)

,. 68 Faust 2/19/85, pp. 74-75; McGovern 2/6/85, pp. 24-25, 49-51; Frederick 3/12/85, pp. 60-61, 69-73; Illjes 2/7/85, p. 11; SP 2301-3D1, Enclosure II, Section 2.4, (Tab 19);

See Volume IV (MPR Report), typendix K for a record of all leak rate calculations wi.h operator-entered data. I 69 Volume IV (MPR Report), Figures IV-14, IV-15, IV-16; l Appendix K.

70 A. Miller 3/22/85, pp. 3 Mehler 2/28/85, pp. 40-44. )

71 Volume IV (MPR Report), Appendix K, Test Numbers 88 and 115.

72 Volume IV (MPR Report), Table VI-1.

73 McGovern 2/6/85, pp. 25-26; Coleman 2/5/85, p. 10; Congdon 2/13/85, p. 16; Frederick 3/12/85, p. 78; Guthrie 2/12/85, p. 8; Hoyt 2/26/85, pp. 43-4G; Adams 3/13/85, p. 16.

74 Volume IV (MPR Report), Table V-3; For logging practices generally, seer McGovern 2/6/85, pp. 19-21; Congdon 2/13/85, pp. 23-24; Faust 2/19/85, pp.99-101; Frederick 3/12/85, pp. 54-55, 80-82 A. Miller 3/21/85, p. 20.

75 Zewe 2/27/85, pp. 19-20; Adams 3/8/85, pp. 42-44; Hoyt 2/14/85, pp. 24-26.

76 Adars 3/19/85, p. 13; Coleman 2/5/85, pp. 32-33; Hoyt 2/26/85, pp. 4, 8 IJ1jes 2/7/85, pp. 12-13, 15-16; A. Miller 3/21/95, pp. 20-23; Faust 2/19/85, pp. 125-127, 136, 138-139.

- 151 - [ corrected 1/17/86]

106 Volume IV (MPR Report), Appendix K, Test Numbers 127, 4

- 125, 124, 123, 122 and 121.  ;

- 107 Ibid., Appendix K, Test Number 123.

108 Ibid., p. V-22.

109 Ibif.., Appendix K, Test Number 96.

110 TMI-2 Jct Tickets Numbers:

C0013, Decert>cr 5, 1978; C0345, Der: ember 25, 1978; C0621, Jenaary 10, 1979 (Tab 7).

111 Shift Supervisor Turnover Notes, January 2 - 10, 1979, (Tab 10).

112 McGovern 2/6/85, pp. 34-37, 70-71, 86; Guthrie 2/12/85, pp. 16-17, 61-62; Faust 2/19/85, p. 16; 2/20/85, pp. 18-21; A. Miller 3/20/85, pp. 86-87; Adams 3/8/85, pp. 47-53; 3/13/85, pp. 140-141; Fraderick 3/14/85, pp. 66-67, 71, 103-105.

113 7th ticket C0013, (Tab 7).

114 Volreo IV (MPR Report), Appendix K, Test Number 111.

115 Ibid., Appendix K, Test Numbers 111, 110, 107, 106, g 105, 102, 100, 99, 97, 94, 92, 90, 88, 86, 85, 83, 82, I 81, 78, 76, 75, 74, 73, 72, 71, 68, 67, and 66.

116 Ibid., Appendix K, Test Numbers 109, 101, 98, 96, 95, 93, 91, 80, 79, 70 and 69.

117 Ibid., Appendix K, Test Number 98.

118 Job Ticket C0013, (Tab 7).

119 Volume IV (MPR Report), Figure IV-20.

120 Ibid., Figure V-5; Appendix K, Test Numbers 74 - 66.

121 Ibid., Figure V-5.

- 155 - [ corrected 1/17/86]

s

- 167 No one we interviewed made such an argunent or even s cont. indicated an awareness of the calculation error concerning water additions. The only such knowledge

. was expressed in an early statement by Coleman (4/10/80, p. 3). However, his more recent testimony does not indicate that either he or anyone else

~

intended to compensate for the drain tank calculation error by adding water to the makeup tank. Coleman (2/5/85) pp. 61-62.

168 Volume IV (MPR Report), Appendix A; pp. IV.14 - IV.16 l 169 Coleman 2/5/85, pp. 54-59; 2/20/85, pp. 1-5.

170 Volune IV (MPR Report), Appendix K, Test Numbers 36, 29, 27, 26, 25, 21, 20, 19, 18, 17, 16 and 12.

171 Ibid., Appendix K, Test Numbers 11, 9, 8, 7, 6, 5, 4, 3, 2 and 1.

The remaining test filed during this period (No. 10) is also suspect. Its corresponding strip chart trace shows a rise characteristic of a hydrogen addition.

172 Daily Plant Status Report March 15, 1979, (Tab 10);

McGovern 2/6/85, p. 101; Hoyt 2/26/85, p. 146.

173 TMI-2 Tenporary Change Notice (TCN) 2-79-070, March 16, 1979, (Tab 21);

See Volume IV (MPR Report), pp. III.6 - III.7.

174 Volume IV (MPR Report), Figure IV-5.

175 Ibid., Figure IV-20.

176 Volume III, Table 1.

177 Hartman, 4/27/80, pp. 91-92.

178 Volume IV (MPR Report), Table VI-2, 179 Ibid.,Section IV.

180 Ibid., pp. IV.4-IV.11.

- 159 - [ corrected 1/17/86]

181 Ibid., pp. IV.13-IV.34.

182 Ibid., pp. IV.24-IV.27.

193 Ioid., pp. IV.22-IV.24.

184 Ibid., Figure IV-2. l 185 TMI-2 Shift Foreman Log Book, October 5-8, 1978, pp. 285-297, (Tab 49).

i 186 Signed-off Data Sheets (for reactor building sump surveillance), in SP 2301-3Dl, December 18, 1978, (Tab 40);

Shift Foreman Log, December 18-19, 1978, pp. 63-69, (Tab 49);

TMI-2 Control Boon Log Book, December 18-19, 1978, pp. 399-402, (Tab 4R).

187 Control Poom Log, 2/2/79, p. 481 (Tab 48);

Shift Foreman Log 2/2/79, p. 213; (Tab 49).

188 Vol. III, Table IV.

189 Vol. IV (MPR Peport) Appendix K, Test Numbers 149, 148, 147, 146, 145; "Estinated Unidentified Leakage" These estimated leakage values are obtained by a method involving the slope / water addition calculations and these numbers represent the Unidentified Leakage at 501'F. They are presented here only for comparative purposes with the Unidenti fied Leakage obtained by the operator using the TMI-2 leak rate test procedure. It should be noted that these estimated leakage values would be reduced by a factor of 1.396 when corrected to room temperature, and it is these corrected values which should be compared to the allowable Unidentified Leakage rate of 1.0 gpm. See Vol. IV (MPR Feport),

Section IV.

190 Volume IV (MPR Feport), Appendix K, Test Nunber 170.

191 Ibid., Appendix K, Test Nurber 154.

192 Ibid., Appendix K, Test Number 153.

(

I l

- 160 - [ corrected 1/17/861 l

t . _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ - _

193 Ibid., Appendix K, Test Numbers 152 through 143, f inclusive.

194 Ibid.,Section III, p. III.4; Appendix A, pp. A.16-A.18.

195 Daily Plant Status Report, October 18, 1978, (Tab 10). l 196 Congdon 2/13/85, pp. 101-102; Illjes 2/11/85, pp. 3-5; Adams 3/8/85, pp. 92-93, 106; 3/19/85, pp. 7-9,,23-24; Mehler 2/28/85, pp. 38-44.

197 Daily Plant Status Report, October 17, 1978, (Tab 10).

198 Daily Plant Status Report, October 18, 1978, (Tab 10).

194 TMI-2 Work Request No. 5562, October 18, 1978, (Tab 7).

200 Haverkanp 3/3/85, p. 6.

201 Ibid.

202 J.R. Floyd, TMI-2 Operations Memo, October 20, 1978, (Tab 34).

203 LER 78-62/lT, (Tab 29).

204 MPR Note: " Estimated Unidentified Leakage" These estimated leakage values are obtained by a method involving the slope / water addition calculations and these numbers represent the Unidentified Leakage at 581*F. They are presented her only for comparative purposen with the Unidentified Leakage obtained by the operator using the TMI-2 leak rate test procedure. It should be noted that these estimated leakage values would be reduced by a factor of 1.396 when corrected to room temperature, and it is these corrected values which should be compared to the allowable Unidentified Leakage rate of 1.0 gpm. See Vol. IV (MPR Report),

Section IV.

205 Vol. III, Table I.

l 206 Ibid., Table IV pp. 42-43; l THI-2 Analog Trend Record No. 4 (Strip Chart), January l 8-16, 1979, (Tab 44);

(Additional references may be found on next page.)

- 161 - [ corrected 1/17/86]

206 THI-2 Utility Printout (excerpts showing reactor cont. building sump level readings), January 16, 1979, (Tab 42).

207 Vol. III, Table IV:

Job Tickets:

C0450, December 29, 1978; C0668, January 12, 1979; C0674, January 14, 1979, (Tab 7); I

, Shift Supervisor Turnover Notes:

January 2, 1979; January 13, 1979; January 14, 1979, (Tab 10).

Radiation Work Permits (Pwp) No's:

01428C, January 2, 1979, 014306 January 6, 1979, 014324-14330, January 11, 1979, 014340-14341, January 14, 1979, (Tab 9);

TMI-2 Plan-of-the-Day (POD) Meeting Minutes, January 12, 1979, (Tab 22);

Shift Foreman Log Book, January 13, 1979, (Tab 49).

208 SP 2301-3Dl, Section 6.4.4, (Tab 19).

209 Shift Foreman Log, January 13, 1979, (Tab 49).

210 G. Kunder, Notes for " Ops Notes" file, January 13, 1979, (Tab 45).

211 Kunder 3/6/85, pp. 36, 44-46.

212 See Volume IV (MPR Report), Appendix B, p. B.3, Table B-1;

" Standard for Light Water Reactor Coolant Pressure Boundary Leak Detection", Instrument Society of America, ISA-S 67.03, 1982, (Tab 16).

213 Volume IV (MPR Report), Appendix K, Test Number 63.

214 Shift Supervisor Turnover Notes, January 15, 1979, (Tab 10).

215 The leaking valves were replaced during the plant shutdown; See Vol. III, Table IV.

- 162 - [ corrected 1/17/86]

i 259 Statement of Facts, (Tab 2). (Our position is cont. ersentially the same as that of the U.S. Attorney on the lack of any evidence that would require discussion of management involvement in leak rate test practices above the level of Met-Ed Vice President for Generation.)

260 Tech Specs, Section 6.5, (Tab 14);  !

Herbein 2/8/85, pp. 23-26; Lawyer 11/10/83, pp. 6, 7, 41; Troffer 3/20/85, pp. 2-5, 9-10, 39-45. l 261 Herbein, 2/0/85, pp. 26-30; G. Miller 2/15/85, pp. 28, 32-34, 42-43, 70-76; I Logan 3/27/85, pp. 69, 78, 116.

262 Seelinger 4/4/84, pp. 11-14.

263 Logan 11/18/83, pp. 6-7; 3/27/85, pp. 18-19, 69, 78-79, 114-118.

264 A. Miller 3/21/85, pp. 77-78; Zewe 2/27/85, pp. 49-50; Mehler 3/27/84, p. 22; 4/18/84, p. 10; 3/15/85, pp. 11-13; Congdon 2/13/85, pp. 62-65; Hoyt 2/26/85, p. 22-24; Adams 3/8/85, pp. 131-132; Hitz 3/29/84, p. 27; Chwastyk 4/24/84, pp. 17-23.

265 Statement of Facts, p. 13, (Tab 2).

266 Herbein 2/8/85, pp. 40-41; G. Miller 2/15/85, pp. 75-76.

267 Vol. III, Table 1.

268 Shift Supervisor Turnover Notes: October, 1977, (Tab 10);

Daily Plant Status Reports:

October 18, 1978 January 13, 1979 March 27, 1979, (Tab 10);

G. Miller 2/15/85, pp. 8-12, 17, 22-24, 31-32, 56, 69-70.

- 167 - [ corrected 1/17/86]

l 269 Logan 3/27/85, pp. 20-33, 65-66, 72-77, 124-125 G. Miller 2/15/85, pp. 31-32, 69-73 -

l Herbein 2/8/85, pp. 8-9 970 U.S. NRC, Office of Inspection and Enforcement, Inspection Reports: November 6, 1978, January 5, 1979, January 26, 1979, (Tab 33).

271 NRC Inspection Report, January 26, 1979, pp. 10-11, (Tab 33).

272 Ibid., p. 11, (Tab 33).

273 Zewe 2/27/85, pp. 19-20; Beeman 9/29/83, pp. 8-10; Guthrie 2/12/85, pp. 12-13; Smith 2/8/85, pp. 31-32; Adams 3/8/85, pp. 42-44; Hoyt 2/14/85, pp. 25-26; Mehler 2/28/85, pp. 50-51.

274 AP 1010, Section 2.4, (Tab 17).

275 Metropolitan Edison Company, OA Audit Report 78-31, January 24, 1979, (Tab 39); l Loignon 4/22/85, pp. 12-14, 19-24, 27-28, 35-36; Troffer 3/20/85, pp. 40-45.

276 Haverkamp 9/14/83, p. 1; 3/3/85, pp. 3-6.

277 Ibid., 3/3/85, p. 6.

278 Ibid., pp. 6-7.

279 Ibid., pp. 7-12.

280 Ibid., pp. 7-8, 15.

281 Three Test Data Sheets contain handwritten notations by the Supervisor of Operations that appear to be an explanation of the events of October 16-18. According to those notes, when two tests run on October 18 about two hours apart were rounded of f, they showed that unidentified leakage was brought down to 1.0 gpm within four hours. If this explanation had been accepted by PORC, a decision might have been made that these had (continued on next page)

- 168 - [ corrected 1/17/86]

VOLUME II (A)

REPLACEMENT PAGES:

Adams pp. 25, 26, 30 l Coleman p. 11 Conaway p. 18 Congdon pp. 1, 26 Faust p. 21 Frederick pp. 26, 29 Garrison p. 4 l

Guthrie pp. 1, 13, 21

CHARLES ADAMS 1 Adams 3/8/85, pp. 75-76, 99, 169.

2 Ibid., pp. 14-15, 61, 68, 95, 98, 102.

3 Ibid., p. 70.

4 Ibid., p. 130.

5 vol. III, Table 2.

6 Ibid.

7 Adams 3/8/85, pp. 92-93, 129; 3/19/85, p. 13.

8 Adams 3/8/85, p. 131.

9 Ibid., pp. 8, 108-109.

10 Ibid., p. 30.

11 Ibid., pp. 21, 78, 82.

12 Ibid., pp. 138-139.

l 13 Adams 3/8/85, pp. 77-78:

3/13/85, p. 10.

14 Adams 3/8/85, pp. 14-15, 115-116.

15 Ibid., pp. 59, 73, 74.

16 Ibid., p. 81.

17 Adams 3/13/85, p. 5.

18 Congdon 2/13/85, pp. 33-34.

19 Adams 3/8/85, p. 22-23, 118-119, 20 Adams 3/19/85, p. 13.

21 Adams 3/8/85, pp. 118-121.

22 Ibid., pp. 121-122.

23 Vol. III, Table 2. j

[ corrected 1/17/86]

CHARLES ADAMS 24 Vol. III, Table 2.

25 Adams 3/8/85, pp. 14-15.

26 Adams 3/8/85, p. 19; 3/13/85, pp. 11-12.

l 27 Adams 3/8/95, pp. 77-78; 3/13/85, p. 10.

28 Adams 3/13/85, p. 16.

29 Adams 3/8/85, p. 108.

30 Ibid., p. 132, 31 Ibid., pp. 64-65, 68.

32 Ibid., pp. 118-119.

33 Ibid., pp. 75-76.

34 Ibid., pp. 70-71.

35 Vol. IV (MPR Report), Appendix K, Test Numbers 121, 110, 107, 105, 99, 79, 78, 76, 72.

36 Vol. IV (MPR Report), Appendix K, Test Numbers 109, 103, 96, 79, 69.

37 Adams 3/8/85, pp. 47-48; 3/13/85, pp. 120, 140-141.

38 Ibid., pp. 125-126.

39 Ibid., p. 125.

40 Ibid., p. 126.

l I

41 Vol. IV (MPR Report), Appendix K, Test Numbers 78, 76.

42 Ibid., Test Numbers 109, 103, 96, 79.

1 43 Ibid., Test Number 78.

44 Adams 3/13/85, p. 131.

45 Ibid., p. 131. l

[ corrected 1/17/86]

CHARLES ADAMS 112 Adams 3/19/85, p. 13.

113 Ibid., p. 13.

114 Vol. III, Table 2.

115 Vol. III, Table 1 and 2.

116 Vol. IV (MPR Report), Appendix K, Test Number 4.

117 Adams 3/19/85, p. 61.

118 Ibid., p. 61.

l l

l 1

[ corrected 1/17/86]

MARK COLEMAN the course of the test was important in obtaining the desired l

result.51 If the addition was not close to the end of the i test, he believed it would not have the desired effect on the test result.

When questioned whether others knew of, or participated with him in, this practice, Coleman again stated he had no present recollection of anyone else participating." When i

specifically asked whether Dennis Olson knew of the practice, he said he could not be certain whether Olson was aware of the practice.54 But he had a vague recollection of discussing some form of test manipulation with him.

Coleman had no recollection of whether his superiors were aware of his conduct. However, he stated he did not believe he would be disciplined if they found out about his test manipulation.

i A review of the plant documentation pertaining to the leak rate tests performed on Coleman's shift indicates that it is unlikely he participated alone in the water addition method of manipulating leak rate test results.

[ corrected 1/17/86]

t - _ _ _ _ _ _

WILLIAM CONAWAY denied knowing at that time that the makeup tank level strip chart would reflect more water than was actually added by the batch controller. He could not explain why such a large amount of water was added, but conceded that he would have approved the test without asking any questions of his Control Room Operators as to why water had been added. He also admitted that he did not require the use of a Data Sheet to record the water addition as mandated in the leak rate test l procedure.88 Operator Response to Indications of Excessive Leakage Our analysis of plant records reveals that there were at least two periods when Conaway was working when there were indications that unidentified leakage exceeded 1.0 gpm, and the required action was not taken in response to such indications.

Conaway acknowledged that he was aware that the Technical Specifications required that leakage be monitored to ensure compl iance with the limiting condition for operation for RCS leakage. It was his understanding that this was to be done by the performance of a leak rate test.

[ corrected 1/17/86]

[ _ _ _ _ .

l

\

l JOSEPH R. CONGDON is presently employed by GPU Nuclear Corporation at TMI-2 as a Shift Foreman. In 1978-1979, prior to the accident, he was a Control Room Operator at TMI-2.

During this period he normally worked in the control room with k Martin Cooper and Mark Phillippe. Charles Adams was his Shift Foreman and Brian Mehler was his Shift Supervisor.

Analysis of employee testimony, Reactor Coolant Inventory Balance tests (leak rate tests), and related plant documents, suggests that Congdon failed to properly utilize the leak rate test for the purpose of measuring reactor coolant system (RCS) leakage and also failed to take required action in response to indications of excessive RCS leakage in October 1978, January cnd March 1979.

Congdon himself admitted that he knowingly engaged in the manipulation of leak rate tests while an operator at TMI-2 by adding hydrogen to the makeup tank. Furthermore, his testinony, together with plant records, implicates others on his shift in the same practice.

[ corrected 1/17/86)

l JOSEPH R. CGNGDON 83 Vol. III, Table 1, Table 2.

84 Congdon 2/13/85, p. 108.

85 Ibid., pp. 14, 73.

86 Ibid., p. 34.

87

( Vol. III, Table 2:

Vol. IV (MPR Report), Appendix K, Test Numbers 146, I 145, 144, 143.

88 Ibid., Test Numbers 146 and 145.

89 Haverkamp 3/3/85, pp. 5, 10.

90 Congdon 2/13/85, p. 69.

91 Ibid., p. 68.

92 Ibid., p. 74.

93 Ibid., pp. 74-75.

94 Ibid., p. 69.

95 Ibid., p. 70.

96 Ibid., p. 73.

97 Ibid., p. 73.

98 Ibid., p. 74.

99 Ibid., pp. 101-105.

100 Ibid., pp. 101-105.

101 Vol. IV (MPR Report), Figures IV-2, IV-20.

102 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Number 4.

[ corrected 1/17/86]

f L ,

I CRAIG FAUST 20 ' Ibid., pp. 98, 101.

L 21 Faust 2/19/85, p. 95; 2/20/85, p. 59.

22 Faust 2/19/85, pp. 55, 110.

23 Faust 2/20/85, pp. 42-43.

24 Faust 2/19/85, pp. 105-106, 108; 2/20/85, p. 94.

- 25 Faust 2/19/85, pp. 120-126; 2/20/85, p. 59. l

( 26 Faust 2/19/85, pp. 105-107.

27 Frederick 3/12/85, p. 85; Zewe 2/27/85, pp. 11, 40-46.

28 Vol. III, Table 2.

29 Ibid.

30 Vol. IV (MPR Report), Appendix K Test Numbers 94, 75, 74, 73 4 31 Vol III, Table 4; Zewe 2/27/85, pp. 28-29, 95; Frederick 3/14/85, pp. 71, 105; g McGovern 2/6/85, pp. 37-39, 96, 89. I 32 Faust 2/19/85, p. 101.

33 Faust 2/19/85, pp. 139-140, 183-184; 2/20/85, pp. 23-24.

34 Faust 2/20/85, pp. 34-35, 50-52, 75-79.

35 Faust 2/19/85, p. 115.

36 Faust 2/20/85, pp. 53, 75-77.

37 Faust 2/19/85, pp. 16-18; 2/20/85, pp. 5-6.

38 Faust 2/10/85, pp. 17-18.

[ corrected 1/17/86]

EDWARD FREDERICK 16 Adams 3/19/85, p. 13; Coleman 2/5/85, pp. 32-33; Congdon 2/13/85, p. 34; Faust 2/19/85, pp. 110, 132-133, 136, 138-139; Hoyt 2/26/85, pp. 4,8; f Illjes 2/7/85, pp. 11-13, 15-16; McGovern 2/6/85, p. 109; Mehle 2/28/85, pp. 57-60, 63-64, 66; r Miller, A. 3/21/85, pp. 20-23; Zewe 2/27/85, pp. 10-11, 37.

r 17 Vol. IV (MPR Report),Section V.

18 Frederick 3/12/85, pp. 14-15.

19 Ibid., p. 16.

20 Ibid., p. 17, 21 Ibid., p. 17, 22 Frederick 3/12/85, pp. 17-18, 34-35.

23 Frederick 3/12/85, pp. 17-18.

24 Frederick 3/12/85, pp. 76-77; 3/14/85, pp. 76-77 25 Frederick 3/12/85, pp. 80-81; 3/14/85, p. 194 Faust 2/19/85, pp.99-100.

26 Frederick 3/12/85, pp. 82, 90-91.

27 Ibid., p. 90.

28 Ibid., pp. 82-83.

29 Ibid., p. 91.

30 Faust, 2/19/85, pp. 94-95, 101.

31 Frederick 3/12/85, p. 92.

32 Ibid., pp. 44, 93.

[ corrected 1/17/86]

EDWARD FREDERICK 72 , Ibid., Test Numbers 85, 78.

73 Ibid., Test Number 50.

74 Ibid., Test Number 150.

75 Vol. III, Table 1.

[

76 Vol. IV (MPR Report), Appendix K, Test Numbers 40, 9, 4, 3, L 2, 1.

, 77 Ibid.

78 Frederick 3/14/85, pp. 190-193.

79 Frederick 3/12/85, pp. 32-33, 162.

80 Ibid., pp. 32-33, 61.

81 Ibid., p. 62.

82 Frederick 3/14/85, pp. 164, 167, 170-171, 174, 176, 179, 186.

83 Frederick 3/12/05, pp. 63-64.

84 vol, IV (MpR Report), Appendix K, Test Numbers 9, 4, 3, 2, 1.

85 Vol. III, Table 4.

86 Vol. IV (MPR Report), Appendix K, Test Numbers 9, 3, 2, 1.

87 Ibid., Test Numbers 40, 4.

88 Frederick 3/12/85, p. 6.

89 Ibid., pp. 100-101.

90 Ibid., pp. 74, 101.

l 91 Vol. III, Table 4; Vol. IV (MPR Report), Appendix K, Test Number 150.

92 Vol. III, Table 1.

93 Ibid., Table 2.

[ corrected 1/17/86]

) .

JACK GARRISON 1 Garrison 2/5/85, p. 8.

2 Ibid., p. 7.

3 Garrison 9/28/83, p. 11; 2/5/85, p. 7.

4 Ibid., pp. 6-9.

5 Garrison 9/28/83, pp. 31-33, 39, 42-43.

6 Ibid., pp. 31, 43.

7 Ibid., p. 42; I

Garrison 2/5/85, p. 31.

8 Garrison 2/5/85, pp. 15-16.

9 TMI-2 Shift Test Engineers Log, October 16, 1978, (Tab 50).

Garrison 2/5/85, p. 16.

10 Ibid., p. 17.

11 Ibid., p. 17.

12 Ibid., pp. 17-18.

13 Ibid., p. 20.

14 Ibid., p. 17.

[ corrected 1/17/86)

I - _ _ _ _ _ _ _ . _ _ _

l l

CARL GUTHRIE began employment with Metropolitan Fdison Company on February 2, 1971. Between March 1978 and March 1979, he worked as a Shift Foreman assigned to TMI-2. During 1978, he was responsible for supervising several Control Poon Operators on different shifts. But by 1979, he was regularly assigned as the Shift Foreman for the shift comprised of Hugh McGovern, Leonard Germer and Earl Hemmila. Kenneth Bryan and Bernard Smith were his Shift Supervisors during most of this time.

Analysis of employee testimony, Reactor Coolant Inventory Balance tests (leak rate tests) and related plant documents reveals that Guthrie failed to properly supervise the performance of leak rate tests and also failed to ensure that required action was taken in response to indications of reactor coolant system (RCS) leakage during October 1978 and March 1979. There is insufficient evidence to support a conclusion that Guthrie participated in, or knowingly tolerated, l

manipulation of leak rate test results.

[ corrected 1/17/86]

l. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

CARL GUTHRIE Response to Excessive Leakage The practice of discarding unsatisfactory test results without documentation has made it difficult to identify every brief period when unidentified leakage may have exceeded 1.0 gpm at TMI-2. However, we have been able to identify and closely examine three periods when there were indications that unid en ti fied leakage exceeded 1.0 gpm. Guthrie was on duty l during two or these periods, in October 1978 and March 1979.

The events of these periods, and the basis for their selection, are more fully discussed in Volume I of this report. For purposes of this section, these periods ,

discussed only to the extent that they relate to action taken by Guthrie in response to the indications of excessive leakage.

First of all, it should be pointed out that Guthrie recognized his responsibility for monitoring and evaluating RCS leakage as a Shift Foreman at TMI-2 in 1978 and 1979. Fe also understood that it was his responsibility to ensure that if limiting conditions of operation for RCS leakage were exceeded,

[

[

appropriate action would be taken by plant personnel.51 l

6 l

[ corrected 1/17/86]

[ . . . .. - _ _ _ _ _ _ _ _ _

, CARL GUTHRIE 1 Guthrie 2/12/85, pp. 5, 17.

2 Ibid., pp. 15-16.

3 Ibid., p. 22.

4 f):id., p. 19.

5 Ibid., p. 22.

6 Ibid., pp. 28, 31.

7 Ibid., p. 18.

8 Ibid., p. 30, 9 Ibid., p. 7 10 Ibid., p. 8.

11 Ibid., pp. 19-20.

12 Ibid., p. 26.

13 Ibid., p. 26.

14 Ibid., pp. 20-22.

15 Ibid., p. 22.

16 Ibid., p. 21.

17 Vol. III, Table 2.

18 Guthrie 2/12/85, p.7.

19 Vol. IV (MPR Report), Appendix K, Test Numbers 59, 57, 55, 52, 51, 49, 47, 42, 37.

20 Vol. III, Table 2.

21 Guthrie 2/12/85, p. 19.

22 Vol. III, Table 2.

23 Vol. IV (MPR Report), Appendix K, Test Numbers 214a, 124, 117.

[ corrected 1/17/86]

u - _ _

VOLUME II (B) f REPLACEMENT PAGES:

Herbein pp. 7, 13, 14, 15 Hoyt pp. 21, 22 Illjes pp. 19, 22 Kunder pp. 12, 14 Marshall p. 7 McGovern pp. 18, 20 Mehler pp. 5, 22, 23, 26, 27 Miller, A. p. 23 Miller, G. pp. 16, 17, 18 Potts p. 6 Ross pp. 2, 3, 5 Smith pp. 23, 27 Troffer p. 8 Zewe pp. 3, 8, 16

, JOHN HERBEIN l

Cannot find leak. Don't believe it is in the RB." It does not appear that copies of the shift turnover notes were attached to the Daily Plant Status Peports transmitted to management in Reading.

Although other witnesses differed on whether Herbein would l generally participate in the daily morning conference call, Herbein believes that his participation was infrequent because l

his duties required him to go to other plant sites and, as a result, he was not always in the office. Additionally, although Herbein admitted receiving the Daily Plant Status Report "on occasion," he did not believe that he received it "on a frequent basis" or "that it was something I focused on." Notwithstanding the discrepancies in the testimony concerning the frequency of Herbein's participation in the morning conference calls and his receipt of the Daily Plant Status Report, the participants we questioned testified that they did not compare entries in the Daily Plant Status Reports from day-to-day and did not notice that identical leak rates were reported for several days. Moreover, these witnesses did not recall discussing continuing problems with leak rate testing in their conference calls.

[ corrected 1/17/86]

j JOHN HERBEIN 1 Herbein 2/15/84, p. 5.

2 Ibid., p. 6.

3 Ibid., p. 7.

4 Herbein 2/8/85, p. 47; 2/15/84, pp. 5-6.

5 Herbein 4/23/84, p. 6.

6 Herbein 2/15/84, p. 9:

2/8/85, p. 9.

7 Herbein 4/23/84, pp. 6-7.

8 Herbein 4/23/84, p. 12; 2/8/85, pp. 27-30, 40; 2/15/84, po. 12-14.

9 Herbein 2/8/85, pp. 40-44.

10 Herbein 2/15/84, pp. 26-27.

l 11 Statement of Facts submitted by the United States, (United States of America v. Metropolitan Edison Company), February, 1984, (Tab 2).

12 Ibid., p. 13, (Tab 2).

13 Herbein 2/8/85, p. 40.

14 Miller, G. 2/15/85, pp. 75-76.

15 Herbein 4/23/84, p. 12.

16 Herbein 2/8/85, pp. 28-30; l 2/15/84, pp. 28-29.

17 Logan 3/27/85, pp. 61-64, 116, 125-130; Miller, G. 2/7/84, p. 23; 2/15/85, pp. 28-32; Potts 1/6/84, p. 19; Troffer 3/20/85, p. 10.

18 Daily Plant Status Reports, (Tab 10).

Vol. III, Table 4.

[ corrected 1/17/86]

l JOHN HERBEIN 19 Shift Supervisor Meeting Minutes, October 5, 1977, (Tab 23).

Logan 3/27/85, pp. 28-29.

20 Shift Supervisor Turnover Notes, October 18, 1978, (Tab 10).

21 Shift Supervisors' Meeting Minutes, October 5, 1977, (Tab 23);

Zewe 2/27/85, pp. 86-87.

22 Herbein 2/8/85, pp. 8-10; Lawyer 11/10/83, pp. 18-19; l Logan 3/27/85, pp. 21-23; Miller, G. 2/7/84, p. 11; 2/15/85, pp. 9-10.

23 Herbein 2/8/85, p. 9.

24 Miller, G. 2/15/85, pp. 31, 56.

Logan 3/27/85, pp. 25-27.

25 Letter, J. Seelinger to B. Grier (NRC), Prompt Report to Reportable Occurrence, October 19, 1978, (Tab 31);

Bezilla 2/22/85, pp. 11-14.

26 THI-2 Licensee Event Report 78-62/lT, November 1, 1978, (Tab 29).

27 Vol. III, Table 1; Vol. IV (MPR Report), Appendix K, Test Numbers 147, l

146, 145 and 144.

28 TMI-2 Licensee Event Report 78-62/lT (Draft), November 1978, (Tab 28);

LER 78-62/lT, November 1, 1978, (Tab 29).

29 Herbein 4/23/84, p. 24.

30 Ibid.

j l

I (corrected 1/17/86]

JOHN HERBEIN 31 Herbein 4/17/85, p. 36.

32 Ibid., pp. 5-8.

33 Ibid., p. 11, 34 Ibid., p. 14.

l 35 Ibid., p. 15, 36 Ibid., pp. 39, 46-47.

37 Ibid., pp. 37-40.

38 Troffer 3/20/85, p. 49; Potts 4/18/85, p. 17.

39 Herbein 4/17/85, pp. 29-30.

f I

[ corrected 1/17/861

! KENNETH HOYT I

20 Hoyt 2/26/85, p. 19.

21 Ibid., pp. 20-23, 22 Ibid., pp. 22-23.

23 Ibid., pp. 22-26, 24 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Numbers 221, 220, 214, 212, 205, 188, 106, 102, 97, 94, 86, 83, 81, 64, 30.

25 Vol. III, Table 2.

26 Ibid., Test Numbers 205, 200, 189, 188.

27 Ibi_d_., Test Numbers 106, 102, 97, 94, 86, 83, 81.

28 Hoyt 2/14/85, pp. 10-13.

29 Ibid., pp. 12-13.

30 Ibid., p. 18.

31 Ibid., p. 52.

32 Ibid., p. 52. #

33 Hoyt 2/26/85, pp. 44, 46-47, 75.

34 voi, Iy (gpR Report), Appendix K, Test Numbers 102, 95, 81, 64, 61, 30, 22, 15, 13.

35 Hartman 4/27/80, p. 97; j

/ 7/26/83, p. 2: I l 3/26/80, p. 19.

36 Hartman 7/26/83, p. 1.

37 Ibid., pp. 1-2.

l 38 Hartman 3/26/80, p. 27, 39 Ibid., p. 30.

[ corrected 1/17/86}

KENNETH HOYT L

40 Hartman 4/27/80, pp. 57-58.  !

41 Hartman 7/26/83, pp. 1-2, 42 Ibid., p. 2.

43 Vol. IV (MPR Report), Appendix K, Test Numbers 95, 81. I 44 Booher 10/17/84, p. 8.

45 Hoyt 2/26/85, pp. 68-69.

46 Vol. IV (MPR Report), Appendix K, Test Numbers 102, 81, 64, 61, 22, 15, 13, 47 Hartman 7/26/83, p. 1.

48 Hoyt 2/26/85, pp. 139-140.

49 Vol. III, Table 2.

50 Vol. IV (MPR Report), Appendix K, Test Numbers 22, 15, 14, 13, 10.

51 Ibid., Test Number 10.

52 Ibid., Test Numbers 64, 30.

53 Vol. III, Table 1.

54 Vol. IV (MPR Report), Appendix K, Test Numbers 64, 30.

55 Hoyt 3/27/80, p. 8.

56 Hoyt 2/26/85, pp. 107-115, 139-140, i

57 Vol. III, Table 2.

58 Vol. IV (f1PR Report), Figure IV-20.

59 Vol. III, Table 2, 60 Ibid.

Icorrected 1/17/86)

1 i

THEODORE ILLJES 1 Illjes 2/7/85, pp. 10-11, 29-31, 35, 41, 43; 2/11/85, p. 19.  !

2 Illjes 2/7/85, pp. 17, 27, 30, 41; 2/11/85, p. 13.  ;

3 Vol. III, Table 2. l 1

4 Ibid.  !

5 Ibid.

6 Illjes 2/7/95, pp. 8-11.

7 Ibid., pp. 11el2.

8 Illjes 2/7/85, pp. 12, 14, 16, 33, 39, 51-52, 78; 2/11/03, p. 13.

9 Illjes 2/7/85, pp. 13, 16-17.

10 Ibid., p. 14.

11 Ibid., pp. 13-16, 37, 45, 12 Ibid., p. 46.

l 13 Vol. IV (MPR Report),Section IV.

14 Vol. III, Table 2.

15 111jes 2/7/85, pp. 17, 33-34; 2/11/85, pp. 17-19.

16 Illjes 2/7/85, pp. 33-34, 114.

17 Ibid., pp. 30-31, 41, 43.

18 Vol. III, Table 2.

19 Ibid.

20 Vol. IV (MPR Report), Appendix K, Test Numbers 127, 111, 102, 68, 67; Figure V-5.

[ corrected 1/17/86}

l h

THEODORE ILLJES 57 Illjes 2/7/85, p. 122.

[ 58 Ibid., p. 122.

59 Vol. IV (MPR Peport), Appendix K, Test Number 11.

60 Illjes 2/7/85, p. 126.

61 Ibid., pp. 72-73.

6 Ibid., pp. 27-28, 63 Ibid., pp. 29-3.0, 33, 57-58.

64 Ibid., p. 29-30 65 Ibid., pp. 29, 57-53.

66 Ibid., p. 35.

67 Ibid., pp. 34, 50-52.

68 Ibid., p. 50.

69 Ibid., pp. 29-30.

70 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Numbers 71, 68, 67, 66.

71 Ibid., Figure IV-20.

72 Illjes 2/11/85, p. 11.

73 Ibid., pp. 10-28.

l 74 Ibid., p. 27, 75 Ibid., pp. 12-14.

76 Vol. IV (MPR Report), Figure IV-20.

77 Vol. III, Table 2.

78 Illjes 2/7/85, pp. 8, 10, 12-13, 15-16.

[ corrected 1/17/86]

\ _ -

GEORGE KUNDER 1 Kunder 9/28/83, p. 4.

2 Ibid., p. 7.

3 Miller, A. 3/22/85, pp. 68-71; Mehler 3/29/85, pp. 13-16; Logan 3/27/85, pp. 106-107.  !

4 Kunder 9/28/83, pp. 11-13; Letter, G. Kunder to N. Palladino, August 13, 1984, (Tab 38).

5 Kunder 9/28/83, pp. 38-40.

6 Ibid., p. 38. l 7 Ibid., p. 41, 8 Ibid., pp. 24-25.

9 Ibid., p. 28.

10 Logan 11/18/83, p. 3.

11 Kunder 3/6/85, p. 50.

12 Kunder 3/6/85, p. 51; 9/28/83, p. 14.

13 Kunder 3/6/85, p. 51.

14 Kunder 9/28/83, pp. 15-16.

15 Ibid., p. 45.

16 Frederick 12/10/82, pp. 3980, 3982, 3987; Guthrie 2/12/85, p. 69; Faust 9/25/81, pp. 874-889. l 17 Metropolitan Edison Co., Position Descriptions for Unit Superintendent Technical Support. (Tab 6).

18 Miller, A. 3/21/85, p. 71; Hoyt 2/26/85, pp. 59-60; Adams 3/13/85, p. 85; Smith 2/8/85, pp. 106-107

~ ~

[ corrected 1/17/86]

GEORGE KUNDER 35 Vol. III, Table 4.

36 Hoyt 2/26/85, pp. 86, 91, 93, 94.

37 Ibid., pp. 95-97.

38 Ibid., p. 127.

39 McGarry 3/1/85, pp. 32-36.

40 Smith 2/8/85, p. 126; Zewe 2/27/85, pp. 114-115.

41 Kunder 3/6/85, pp. 34, 39.

42 Kunder G.A., Informal Notes from " Ops Notes file, January 13, 1979, (Tab 45).

43 Kunder 3/6/85, p. 31.

44 Ibid., pp. 30-34.

45 Ibid., pp. 35, 39-40.

46 Logan 3/27/85, pp. 106-107.

47 Ibid., p. 107.

48 Kunder 3/6/85, pp. 44-47 l

[ corrected 1/17/86}

WALTER J. MARSHALL 25 Letter, J. Seelinger to N. Palladino (NRC), August 9, 1984, (Tab 36).

26 Marshall 3/4/85, pp. 49-50.

2

[ corrected 1/17/86]

HUGH MCGOVERN 23 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Numbers 179, 178, 108, 94, 85, 84, 79, 52, 47, 37, 8, 6, 5, 2. l 24 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Numbers 179, 178.

25 Vol. III, Table 2; Vol. IV (MPR Report), Appendix K, Test Numbers 85, 84, 78.

26 Vol. III, Table 2; Vo'l. IV (MPR Report), Appendix K, Test Numbers 94, 85, 78.

27 McGovern 2/6/85, pp. 81, 89.

28 Ibid., pp. 33-36.

29 Ibid., p. 86.

30 Ibid., p. 89.

31 Ibid., p. 90.

32 Vol. III, Table 2.

33 McGovern 2/6/85, pp. 95, 103.

34 Ibid., pp. 98-99.

35 Vol. IV (MPR Report), Appendix K, Test Nulnberc ~C,/ 6.

36 Ibid., Test Number 78.

37 Vol. III, Table 2.

38 Ibid.;

McGovern 2/6/85, p. 102.

[ corrected 1/17/86]

[ _ _ _ _ _ _ _ - - .

HUGH MCGOVERN l

)

56 Ibid., p. 31.

57 Ibid., pp. 31-32.

l l 58 Vol. III, Table 2.

L 59 Ibid.

60 Ibid.

61 McGovern 2/6/85, pp. 108-112.

62 Ibid., p. 110.

63 Ibid., pp. 111-112 l

l 1

l l

l I

! corrected 1/17/86]

\ _ - - _ _ _ _ _ _ - _ _ _

BRIAN MEHLER Further, Mehler stated that, if there were leakage indications, attempts would be made to identify the leakage for inclusion in the next leak rate test calculation. Once this occurred, the previous tests would be discarded.1 During our interview with Joseph Congdon, he conceded that es it became more difficult to obtain satisfactory results, u

operators would no longer attempt to evaluate or verify leak rate test results. Those showing unidentified leakage greater j than 1.0 gpm were simply discarded.1 When confronted with l

l Congdon's statements, Mehler nevertheless claimed that he believed that the process of evaluating leak rate test results l was never abandoned, and that if tests were found to be valid, l

f they would not be discarded.19 It should be noted that Charles Adams basically maintained the same position as Mehler until he was confronted with plant documentation. Only at that point did he acknowledge that tests were discarded without l

. 20 ovaluation.

Likewise, when Mehler was confronted with plant documentation for January 1979, he conceded his uncertainty about whether tests with unidentified leakage above 1.0 gpm were evaluated before they were discarded. He stated that it was possible that all test results showing leaka,ge above 1.0 1

gpm were discarded without concern for their validity.

[ corrected 1/17/86)

. _ _ _ - _ _ _ _ _ . _ _ _ _ . _ J

I BRIAN MEHLER 1 Mehler 2/28/85, pp. 26-28, 32.

2 Mehler 2/28/85, pp. 25, 28, 64; 3/15/85, p. 160. l 3 Mehler 2/28/85, pp. 25, 28, 45.

4 Mehler 2/28/85, pp. 52-54, 95, 101; 3/29/85, pp. 65-69.

5 Adams 3/8/85, pp. 14-15, 32; Congdon 2/13/85, pp. 37-38.

6 Adams 3/8/85, p. 73.

7 Mehler 3/29/85, pp. 65-69.

8 Mehler 2/28/85, pp. 11-16, 49-50.  !

9 Ibid., pp. 48-50.

10 Ibid., pp. 56-57.

11 Ibid., pp. 25, 64. I L

12 Ibid., pp. 57-58, 64.

13 Ibid., p. 63.

14 Ibid., pp. 58, 60.

15 Ibid., p. 60.

16 Ibid., pp. 60, 67-68.

17 Ibid., pp. 42-44, 68.

18 Congdon 2/13/85, p. 34.

I 19 Mehler 2/28/85, pp. 73-74, 20 Adams 3/8/85, p. 133; 3/13/85, pp. 3-5.

21 Mehler 3/29/85, pp. 10-11.

22 Mehler 2/28/85, p. 54.

[ corrected 1/17/86]

BRIAN MEHLER 23 Mehler 2/28/85, pp. 62, 64.

24 Ibid., p. 74.

25 Adams 3/8/85, pp. 66-67.

26 Ibid., p. 81.

27 Vol. III, Table 2.

28 Mehler 2/28/85, p. 64.

29 Ibid., pp. 37-38.

30 Mehler 3/15/85, pp. 104-109, 131.

31 Congdon 2/13/85, p. 49; l

t Adams 3/13/85, pp. 140-141.

f 32 Tf1I-2 Daily Plant Status Reports, December 20, 1978; January 2, 4, 6, 9, 1979, (Tab 10).

33 Mehler 2/28/85, pp. 10, 13, 88; 3/15/85, p. 133.

34 Ibid., pp. 133-134.

35 Vol. IV (MPR Report), Appendix K, Test Numbers 109, 103, 96, 79.

36 Mehler 3/15/85, pp. 104-108.

1 l 37 Vol. IV (MPR Report), Appendix K, Test Numbers 78, 76.

38 Ibid., Test Number 78.

39 Mehler 3/15/85, p. 120.

l 40 Ibid., p. 121.

41 Ibid., p. 122.

42 Ibid., p. 122.

43 Vol. IV (MPR Report), Appendix K, Test Number 76.

[c.orrected 1/17/86)

BRIAN MEHLER i

l 87 Mehler 3/15/85, pp. 16-17.

88 Ibid., p. 20.

89 Vol. III, Table 4; Mehler 3/15/85, pp. 20-21, 43-44.

90 Ibid., p. 23, 91 Ibid., pp. 23-24.

92 Ibid., p. 78.

93 TMI-2 Licensee Event Report 78-62/lT, November, 1978, (Tabt 28, 29);

Mehler 3/15/85, pp. 72, 75.

94 J. Floyd, Operations Memo 2-78-19, October 20, 1978, (Tab 34);

Mehler 3/15/85, p. 85.

95 Ibid., pp. 76-77.

96 Ibid., pp. 81, 83-84, 87.

97 Ibid., pp. 85-86.

98 Ibid., pp. 86-87.

99 Vol. IV (MPR Report), Appendix K, Test Numbers 72, 69, 63.

100 Vol. III, Table 2.

101 Vol. III, Table 4; Mehler 3/15/85, pp. 142-149; 3/29/85, pp. 3-7, 12-13, 16.

102 Mehler 3/15/85, p. 148.

103 Shift Supervisor Turnover Notes, Jat.uary 13, 1979, (Tab 10);

Mehler 3/29/85, pp. 7, 9.

104 Ibid., pp. 9-10.

[ corrected 1/17/86]

l L

BRIAN MEHLER 105 Mehler 3/29/85, pp. 10-11.

106 voi, IV (gpR Report), Figure IV-20.

107 Vol. III, Table 2.

108 Vol. IV (MPR Report), Appendix K, Test Numbers 24, 23, 4.

109 Mehler 2/28/85, p. 8.

110 Ibid., p. 64.

-:7-

[ corrected 1/17/86]

L _ _ _ _ _ _ _ _ _ - .

ADAM MILLER recorded for his shift on only three occasiones. Plant documentation indicates that, during this same period, actual I

unidentified leakage exceeded 1.0 gpm.

Plant data was reviewed with Miller, particularly those documents relating to makeup tank level, sump level and leakage problems. He reviewed the reactor building sump data for January 12 indicating that there were ten sump pump starts on that day. He also reviewed data for the month through January 13 indicating an ongoing unquantified leak in the pressurizer area. Miller acknowledged he was probably aware of this information.1 No leak rate tests were filed on his shift for January 12 or 13, leading us to suspect that unsatisfactory results were obtained and discarded.122 Miller was asked if there was any justification for discarding leak rate test results indicating unidentified leakage above 1.0 gpm given the plant conditions at that time. He conceded that there would be no justification for doing so, considering the seriousness of the leakage problem.123

[ corrected 1/17/86]

l 4

GARY P. MILLER 1 Miller, G. 2/7/84, p. 23; 2/15/85, p. 28.

2 Ibid., p. 29.

l 3 Ibid., p. 32.

4 Miller, G. 2/7/84, pp. 38, 40; 2/15/85, pp. 42-43, 76.

5 Miller, G. 2/7/84, p. 41; 2/15/85, p. 43.

6 Ibid., pp. 19-20, 35.

7 Ibid., pp. 33-36.

8 Miller, G. 2/7/84, pp. 22-23, 26-27; 2/15/85, pp. 33-36, 42.

9 Ibid., p. 59.

10 Ibid., p. 57.

11 Ibid., p. 3.

12 Ibid., pp. 4, 78.

13 Ibid., p. 6.

14 Ibid., p. 7.

15 Ibid., p. 8.

16 Ibid., p. 9.

17 Ibid., p. 28.

18 Miller, G. 2/7/84, p. 13.

19 Miller, G. 2/15/85, p. 21.

20 Miller, G. 2/7/84, p. 25.

21 Miller, G. 2/7/84, p. 21; 2/15/85, pp. 25, 37.

22 Ibid., p. 14.

[ corrected 1/17/86]

f GARY P. MILLER 23 Miller, G. 2/15/85, p. 26. l l

24 Ibid., pp. B-9.

25 Ibid., p. 24.

26 Miller, G. 2/7/84, p. 11; 2/15/85, p. 23.

27 Miller, G. 2/7/84, p. 12. l 28 Miller, G. 2/15/85, pp. 23-24.

29 Miller, G. 2/7/84, p. 12, 30 Miller, G. 2/15/85, p. 69.

31 Ibid., pp. 11, 25.

32 Ibid., pp. 11-12.

33 Shift Superviosors' Meeting Minutes, October 5, 1977, (Tab 23).

34 Miller, G. 2/15/85, pp. 17-18, 45-46. l 35 Ibid., pp. 12, 18. l 36 Ibid., p. 13.

37 Ibid., p. 14.

38 Ibid., p. 14, 39 Ibid., p. 22.

40 TMI-2 Daily Plant Status Reports, (Tab 10);

Vol. III, Table 4.

41 Miller, G., 2/15/85, p. 31.

42 Ibid., p. 56, 43 Ibid., p. 57.

44 Ibid., pp. 23, 32.

~ ~

[ corrected 1/17/86]

GARY P. MILLER 45 Miller, G. 2/15/85, p. 42.

46 Ibid., pp. 29-30; Beeman 9/29/83, p. 8.

47 TMI-2 Daily Plant Status Reports and Shift Supervisor Turnover Notes, 12/31/78, 1/3/79, (Tab 10).

48 Ibid., pp. 53, 67.

49 Ibid., p. 67 50 Ibid., pp. 69-70.

51 Vol. III, Table 4.

52 Miller, G. 2/15/85, pp. 50, 69-70.  !

53 Ibid., p. 66.

54 Daily Plant Status Report and Shift Supervisor Turnover Notes, March 17, 1979, (Tab 10).

55 Ibid., (Tab 10).

56 Miller, G. 2/15/85, p. 72.

57 Ibid., p. 74.

58 Ibid., pp. 37, 74.

59 Statement of Facts Submitted by the: United States, (United States of America v. Metropolitan Edison Company), February 1984, (Tab 2).

60 Miller, G. 2/15/85, pp. 75-76.

k.

3.;

~

[ corrected 1/17/85]

WILLIAM POTTS 1 potts 1/6/84, p. 5.

2 Ibid., p. 14.  !

3 Ibid., p. 19.

4 Ibid., pp. 18-19.

5 Troffer 3/20/85, p. 10.

6 TMI-2 Licensee Event Report 78-62/lT, (Tabs 28, 29).

7 potts 3/7/85, p. 3.

8 TMI-2 Licensee Event Report No. 78-62-lT, November 1, 1978, (Tab 29).

9 potts 3/7/85, p. 9.

10 Ibid., pp. 5-6.

11 Ibid., p. 3.

12 Ibid., pp. 3-4.

13 Ibid., pp. 5-6.

14 Potts 4/18/85, pp 11-12.

15 Ibid., p. 15.

16 Ibid., p. 18.

17 Ibid., pp. 16-17.

18 Ibid., p. 18.

19 Ibid., p. 17.

20 Troffer 3/20/85, pp. 34-35; Herbein 4/17/85, pp. 39-40.

21 Potts 4/18/85, p. 20.

22 Ibid., p. 21.

[ corrected 1/17/86]

MICHAEL J. ROSS we identified, or during any of the shifts in which manipulated leak rate tests were filed.

Given his very limited exposure to TMI-2 during these training periods, it cannot be inferred from his mere presence that Foss would have become aware of the improper leak rate testing practices. We did not find direct evidence from any other source which suggested that Ross condoned leak rate test misconduct at TMI-2.

Ross has denied that he was aware of any such misconduct.

Specifically, he testified that he did not know that any operators had added hydrogen or water to the makeup tank at TMI-2 in order to manipulate test results.4 He added that he had no reason to believe that other high level managers were aware of test manipulation. Ross also stated that he did not discuss problems pertaining to the performance of TMI-2 leak rate tests with James Floyd, Shift Supervisors or Shift Foremen. He pointed out that he did not normally attend TMI-2 PORC meetings and did not attend TMI-2 POD meetings.

His testimony in this regard is supported by the testimony of I Floyd.8 Ross acknowledged that he did attend staff meetings with TMI-2 managers from time to time, but said that they did r.o t discuss leak rates or routine day-to-day operations at 2- [ corrected 1/17/86]

MICHAEL J. ROSS these meetings. Instead, they focused primarily on matters i relating to the planning and scheduling of Unit operations.9 l

Ross stated that, to his knowledge, management had made no decision to continue to operate TMI-2 with excessive leakage until TMI-l completed refueling and was placed back into operation.1 He also said that he did not know of any Shift Supervisor recommendation to shut down TMI-2 that was overruled because TMI-l was out of service at the same time.11 We found no evidence to refute his testimony. Several TMI employees were questioned specifically regarding Ross's know-ledge of improper leak rate testing practice, but no one has testified directly that Ross was aware of any wrongdoing.

We reviewed all available TMI-2 records related to leak rate test misconduct, but found none that would have been reviewed by Ross and put him on notice of the miaconduct.

Mark Coleman was the only employee whose testimony even remotely implicated Ross in improper conduct. Coleman test-ified that when he first began performing leak rate tests at TMI-2, he turned in a test result showing unidentified leakage in excess of 1.0 gpm and his Shift Supervisor told him that, "We don't want to see this shit around here..13 Coleman

[ corrected 1/17/86]

k

MICHAEL J. ROSS 1 Ross 1/25/84, p. 8.

2 TMI On-The-Job Training Reviews / Experience Records for l M.J. Ross, 1978 and 1979, (Tab 54).

L 3 Ibid., (Tab 54);

Vol. III, Table 1; Vol. IV (MPR Report), Figure IV-20.

4 Ross 1/25/84, pp. 74, 78, 80-81.

5 Ibid., pp. 81, 93.

l 6 Ibid., pp. 92-93.

7 Ibid., pp. 26, 28.

8 Floyd 3/30/04, pp. 13-14.

9 Ross 1/25/84, pp. 9, 93.

10 Ibid., pp. 85-86.

11 Ibid., p. 86.

12 Smith 3/26/84, pp. 24, 42; Mehler 3/27/84, pp. 32, 43, 77; Hitz 3/29/84, pp. 38-39; 4/24/84, p. 57.

13 Coleman 4/25/84, pp. 5-6.

14 Coleman 2/5/85, pp. 33-34, 37, 44-45; 4/25/84, pp. 6-8.

15 Vol. III, Table 1.

16 TMI Units 1 and 2 Shift Assignment, January 6, 1978, (Tab 4);

Coleman 2/5/85, p. 46; Hitz 3/29/84, pp. 30-31.

[ corrected 1/17/86]

t - - _ _ _ _ _ _ _ _ .

BERNARD SMITH 22 Vol. III, Table 2.

23 Smith 3/26/84, p. 20.

24 Ibid., p. 13.

25 Smith 2/8/85, pp. 48-49, 26 Smith 3/26/84, p. 13-4/25/84, p. 5. l 27 Smith 3/26/84, pp. 18-19.

28 Smith 2/8/85, pp. 55-56, 75.

29 Ibid., pp. 65, 72.

30 Hoyt 2/26/05, pp. 22-26.

31 Smith 2/8/85, p. 16.

32 Ibid., p. 26.

33 Ibid., p. 27.

34 Ibid., pp. 28, 58-59.

35 Ibid., pp. 56, 128.

36 Ibid., pp. 95, 98, 126, 1

37 Ibid., pp. 9-12.

38 Ibid., p. 14.

39 Ibid., p. 98.

40 Ibid., p. 77.

41 Ibid., p. 75.

42 Ibid., p. 7 6 .,

43 Ibid., p. 77.

44 Ibid., pp. 77-78.

45 gid., p. 76.

[ corrected 1/17/86]

2

l l

BERNARD SMITH 100 Ibid., Test Number 150, 10.

101 Smith 2/8/85, p. 83.

102 Ibid., p. 83.

103 Vol. IV (MPR Report), Appendix K, Test Number 10.

104 Partman 7/16/82, p. 109; 7/26/83, p. 2.

l

[ corrected 1/17/86)

GEORGE TROFFER 1 Troffer 3/20/85, p. 2.

2 Ibid., p. 10.

3 Met Ed OA Audit Report 78-31, January 24, 1979, (Tab 39).

4 Loignon 4/22/85 pp. 27-29.

5 Ibid., pp. 35-36.

6 Ibid., pp. 29.

7 Troffer 3/20/85, pp. 40-41.

8 Ibid., p. 45, 9 TMI-2 Licensee Event Report 78-62/lT (Draft), November, 1978, (Tab 28);

TMI-2 Licensee Event Report 78-62/lT, November 1, 1978, (Tab 29).

10 Ibid.

l 11 Troffer 3/20/85, p. 11.

12 Ibid., pp. 22-23.

13 Ibid., pp. 23-24.

14 Ibid., p. 27 15 Ibid., p. 27 16 Ibid., pp. 27-28.

17 Ibid., pp. 3-4 18 Ibid., pp. 29, 39.

19 Ibid., pp. 38-39.

20 Ibid., p. 35.

21 Ibid., p. 34.

22 Ibid., p. 49, 23 Potts 4/18/85, p. 17.

-0~

[ corrected 1/17/86]

WILLIAM ZEWE l

l 1

Zewe said that he was aware that leak rate tests at times l provided variable results or results that were ridiculous.5 He also recalled that operators generally complained about the i occuracy of the test results.6 They could not be relied upon )

i without verification from other plant instruments.

1 Despite these statements, when he was asked whether the leak rate test allowed him to determine if RCS leakage was  ;

exceeding limits, he would not directly answer the question.

He initially stated that the leak rate test allowed them to operate the plant sa fely. When pressed further, he stated that they were using what they had available and that he felt it was safe. When asked the question again, he finally stated, "I repeat, that is what we used and that is what we had available. That is what we used it for. I didn't stop to try to analyze it, like we are trying to do now. I just did it."

Zewe testified that he now realizes that the leak rate test was not accurate; however, he could not explain why the inadequacies of the leak rate test program were not apparent to him in 1978.10 Nor did he recall ever personally taking any steps to improve upon the accuracy of the test procedure.1 (corrected 1/17/86]

[ _ ._______ _ _ _ _ _ _ _ _ _ _ _ - _ . . _ . _

WILLIAM ZEWE

{

have been advised of the leak rate unless there was a problem. He stated that he regularly conducted plant tours cnd inspections for RCS leaks. He would also evaluate the  ;

cafety implications of RCS leakage that was brought to his f ettention and would generally advise his superiors and other i cupervisors of his findings in a variety of informal ways.31 l Zewe tes ti fied that he was generally aware of problems that l were being expressed in the control room. He recognized l that he was ultimately responsible for ensuring that proper action was taken in response to excessive RCS leakage.

For the most part, Zewe was not able to recall very much about periods in which there was high unidentified RCS leakage. Instead, he was only able to provide some general ctatemente about his knowledge of operator response to RCS leakage and his opinions of their practices.

For example, Zewe acknowledged that there were problems associated with leak rate testing and that it did not allow for a completely accurate assessment of whether leakage was exceeding 1.0 gpm. He also stated that he believed that the 1.0 gpm limit was unreasonable and not necessarily related to the safe operation of the plant. He was not really concerned about the inability to precisely measure RCS leakage,

[ corrected 1/17/86)

WILLIAM ZEWE 1 Zewe 2/27/85, pp. 11-12.

2 Ibid., p. 5.

r 3 Ibid., pp. 7-8.

4 Ibid., pp. 5-9.

5 Ibid., pp. 29-30.

6 Ibid., pp. 27, 33-94.

7 Ibid., p. 10.

8 Ibid., pp. 13-14.

9 Ibid., p. 32.

10 Ibid., pp. 33, 35, 11 Ibid., p. 34.

12 Ibid., pp. 50-52.

13 Ibid., p. 11.

14 Ibid., pp. 44-45.

15 Ibid., p. 45.

16 Ibid., p. 41.

17 Faust 2/19/85, pp. 95, 101-102.

18 Frederick 3/12/85, pp. 76-77 19 Vol. III, Table 2.

20 Zewe 2/27/85, pp. 46-47.

21 Ibid., pp. 37-38.

22 Ibid., pp. 35-37.

23 Ibid., pp. 35-36, 24 Zowe 2/27/85, p. 37.

[correcte.1 '. /17/86]

VOLUME III (B) i REPLACEMENT PAGE:

L 1

Table 3, last page I t

r 1

SHAFFER, Merrill 11/16/83 Statement to NRC SIEGLITZ, Richard 1/4/83 Excerpts from B & W Transcript 2/15/85 Stier Investigation SMITH, Bernard 3/27/80 NRC I & E 3/26/84 NRC OI 4/25/84 Stier Investigation 2/8/85 STAIR, James 5/12/80 F & B Interview 8/5/83 NRC Report of Intervjew 3/1/85 Stier Investigation 4/18/85 STUPAK, Joseph 8/3/83 Statement to NRC TROFFER, George 3/20/85 Stier Investigation WARREN, Ronald 9/29/83 NRC OI -

WEAVER, Douglas 3/5/85 Stier Investigation WENTLING, William 8/3/83 Statement to NRC VILSON, David 8/3/83 Statement to NRC ZECHMAN, Rithard 8/25/83 Statement to NRC 2 EWE, William 5/21/82 Excerpts from B & W Transcript 5/26/82 11/18/82 11/22/82 11/30/82 12/2/62 3/29/84 NPC OI j 2/27/E5 Stier Investigation l l  ;

fcorrected 1/17/66]

VOLUME V (A)

INSERT PAGE:

p. 7 of Document Index l

l l

50 TMI-2 Shift Test Engineer's Log (excerpt) October 16-20, 1978.

51 TMI-2 Computer Log (excerpts):

April 8-12, 1978 May 23, 1978 k May 25, 1978 October 18, 1978 November 18, 1978 November 21, 1978 December 14, 1978 52 N'otes taken by Attorney at NRC Interview of M. Coleman, April 10, 1980.

53 TMI-2 Field Questionnaire No. 2669, Makeup Tank and Level Transmitters, November 10, 1978.

I

\

54 On-the-Job Training Quarterly Review: M. J. Ross, (1977-1978, 1978-1979, 1979-1980).

55 Floyd, J. R., Operations Memo 2-79-01, January 25, 1979.

l l

(corrected 1/17/86]

VOLUME V (B)

INSERT PAGES:

Tab 10 Daily Plant Status Report, 3/27/79

[ Insert at end of Tab 10, after DPSR for 3/26/791 Tab 14 TMI-2 Technical Specifications, pp. 1-3 and 1-4

[ Insert after cover pg. of Tab 14 (before p. 3/4 4-13)]

Also: p. 7 of Document Index I

l

\

50 TMI-2 Shift Test Engineer's Log (excerpt) October 16-20, 1978.

51 TMI-2 Computer Log (excerpts):

April 8-12, 1978 May 23, 1978 l

May 25, 1978 October 18, 1978 November 18, 1978

( November 21, 1978 December 14, 1978 i l

52 Notes taken by Attorney at NRC Interview of M. Coleman, April 10, 1980.

53 TMI-2 Field Questionnaire No. 2669, Makeup Tank and Level Transmitters, November 10, 1978.

54 On-the-Job Training Quarterly Review: M. J. Ross, (1977-1978, 1978-1979, 1979-1980).

55 Floyd, J. R., Operations Memo 2-79-01, January 25, 1979.

l

[ corrected 1/17/86]

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DEFINITIONS D CHANNEL FUNCTIONAL TEST i 1.11 A CHANNEL FUNCTIONAL TEST shall be: -

l

a. Analog channels - the injection of a simulated signal into the channel as close to the primary sensor as practicable to verify OPERABILITY including alarm and/or trip functions,

b. Bistable channels - the injection of a simulated signal into the channel sensor to verify OPERABILITY including alann and/or trip functions.

CORE ALTERATION I 1.12 CORE ALTERATION shall be the movement or manipulation of any com-ponent within the reactor pressure vessel with the vessel head removed and fuel in the vessel. Suspension of CORE ALTERATIONS shall not preclude completion of movement of a component to a safe conservative position.

SHUTDOWN MARGIN 1.13 SHUTOOWN MARGIN shall be the instantaneous amount of reactivity by which the reactor is suberitical or would be suberitical from its present condition assuming:

a. No change in axial power shaping rod position.

b. All control rod assemblies (safety and regulating) are fully inserted except for the single rod assembly of highest re-activity worth which is assumed to be fully withdrawn.

!DENTIFIED LEAXAGE 1.14 IDENTIFIED LEAKAGE shall be:

a. Leakage (except CONTROLLED LEAKAGE) into closed systems, such as pump seal or valve packing leaks that are captured and conducted to a sump or collecting tank,

b. Leakage into the containment atmosphere from sources that are both specifically located and known either not to interfere with the operation of leakage detection systems or not to be PRESSURE BOUNDARY LEAKAGE.

THREE MILE ISLAND - UNIT 2 1-3

DEFINITIONS

c. Reactor coolant system leakage through a steam generator to the secondary system. -

UNIDENTIFIED LEAKAGE

! 1.15 UNIDENTIFIED LEAKAGE shall be all leakage which is not IDENTIFIED

( LEAKAGE or CONTROLLED LEAKAGE.

! PRESSURE BOUNDARY LEAKAGE 1.16 PRESSURE BOUNDARY LEAKAGE shall be leakage (except steam generator ,

tube leakage) through a non-isolable fault in a Reactor Coolant System component body, pipe wall or vessel wall. l

)

CONTROLLED LEAKAGE 1.17 CONTROLLED LEAKAGE shall be that seal water flow supplied from the reactor coolant pump seals.

QUADRANT POWER TILT 1.18 QUADRANT POWER TILT is defined by the following equation and is expressed in percent.

QUADRANT POWER TILT =

Power in any core cuadrant 100 ( Average power of all quadrants , z)

DOSE EQUIVALENT I-131 1.19 OOSE EQUIVALENT I-131 shall be that concentration of I-131 (uct/ gram) thich alone would produce the same thyroid dose as the quantity and isotopic mixture of I-131. I-132. I-133. I-134 and I-135 actually present.

The thyroid dose conversion factors used for this calculation shall be those listed in Table III of TID-14844. " Calculation of Distance Factors for Power and Test Reactor Sites."

I T - AVERAGE DISINTEGRATION ENERGY 1.20 T-AVERAGE DISINTEGRATION ENERGY shall be the average (weighted in proportion to the concentration of each radionuclide in the reactor coolant at the time of sampling) of tne sum of the average beta and gamma energies THREE MILE ISLAND - UNIT 2 1-4

VOLUME V (C)  !

INSERT TAB:

Insert Tab 34 before Operations Memo 2-78-19, Oct. 20, 1978.

[This memo consists of two pages immediately preceding Tab 35]

l Remove already existing Tab 34 [placed inadvertently in the middle of Tab 33]

1 Also: p. 7 of Documeat Index

50 TMI-2 Shift Test Engineer's Log (excerpt) October 16-20, 1978.

51 TMI-2 Computer Log (excerpts):

April 8-12, 1978 May 23, 1978 May 25, 1978 October 18, 1978 November 18, 1978 November 21, 1978 December 14, 1978 52 Notes taken by Attorney at NRC Interview of M. Coleman, April 10, 1980.

53 TMI-2 Field Questionnaire No. 2669, Makeup Tank and Level Transmitters, November 10, 1978.

54 On-the-Job Training Quarterly Review: M. J. Ross, (1977-1978, 1978-1979, 1979-1980). l g

l 55 Floyd, J. R., Operations Memo 2-79-01, January 25, 1979.

l l

[ corrected 1/17/86)

VOLUME V (D)

INSERT PAGES: 1 Tab 47 Daily Attendance Sheets (October 10, 12, 13, 14, 1978)

[ Insert after first Daily Attendance Sheet (1/16/78)]

p. 7 Document Index ADDITIONAL TABS:

Tab 54 On-the-Job Training Quarterly Review: M. J. Ross Tab 55 Operations Memo 2-79-01, January 25, 1979

50 TMI-2 Shift Test Engineer's Log (excerpt) October 16-20, 1978.

51 TMI-2 Computer Log (excerpts):

April 8-12, 1978 May 23, 1978 May 25, 1978 October 18, 1978 November 18, 1978 November 21, 1978 December 14, 1978 52 Notes taken by Attorney at NRC Interview of M. Coleman, April 10, 1980.

4 53 TMI-2 Field Questionnaire No. 2669, Makeup Tank and Level Transmitters, November 10, 1978.

54 On-the-Job Training Quarterly Review: M. J. Ross, (1977-1978, 1978-1979, 1979-1980). l 55 Floyd, J. R., Operations Memo 2-79-01, January 25, 1979.

[ corrected 1/17/86]

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1. Power changes > 101 with Reactor Control 5tation in fianual.

2. Control Rod Ortve tianipulation fron Subcritical to the Point of Adding Heat.

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            ;              8. O!VER$1TY CF (IPERl[NCE (' lot PeaClivity llanipulations)                           -

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1. Pomer changes > 10% mith Reactor Control Station in finnual.

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3. Beretten and Deboration Maneuver involving Control Rod Manipulation.

4 Turbine $tartue and $ N tdo m .

l. Anector Trip and kbseg,ent Action.

6. Other.

8. '0IVERSITT OF (UCRItxt (mot Reactivity fianipulations) 1 krveillance Testing

a. tatraent spray

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d. Press.rtrer

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f. Feedwa ter

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d. Rod uttNrs=al Indes

e. Reactivity Balance

4. Portable hP Instree*t 'Jte

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a. Contalwnt spray

b. Satety injec tion 2

                                                                                                                                                                               ~

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d. Press rtrer

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f. Feedwater

1. Con tro' tc<r C a lt . fat'ons >

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c. Asta' Power 1941 a *( e '

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\ r METROPOLITAN EDISON C O M P A N Y so.e. . ., c.,,,, i %,. ui,i,,, c......... Sabject PROPER COMPLETION OF OPERATING PROCEDURES Location TMI Nuclear Station OPS MEMO 2-79-01 Middletown, Pa. Dats Jan. 25, 1979 To SHIFT SUPERVISORS SHIFT FOREMEN - UNIT II I CONTROL ROOM OPERATORS - 11 NIT II l A recent NRC audit of operating procedures, see attached sheets, revealed a large number of discrepancies. There is no excuse for the majority of these items. They can be eliminated by the persons performing the procedures taking a few extra minutes to apply some attention to details. Each item in itself seems insignificant, but two pages full indicates a laxity on our part in properly executing the responsibilities that accompany the operating license. In an effort to ensure that procedures are completed properly please use the following guidelines.

l. When completed, the Shift Foreman should review the procedure to ensure that it is properly completed, signed and dated.

[

2. When entering a procedure at a point other than the beginning;

1) Sign off all the applicable pre-requisites and indicate N/A if not applicable.

2) Mark steps in the body of the procedure up to the point I of entering N/A. I

3) Flag the point of entering the procedure with the date and )

present plant conditions.

3. Do not use file and working copies as sign off copies. If the

                        ,   working copy is used as the signoff copy ensure that it is filed as the sign-off copy and not return to the file as the                                                                  .

working copy. I

4. When changing a working or file copy of a procedure you must use a TCN and follow with a PCR when necessary.

5. Ensure that when recording data, that it is entered on the data sheet properly.

6. When performing evolutions which require paperwork, boron dilutions, neutralizer tank dumps, etc. ensure that the accompanying paper work is properly completed.

7. If performing a certain section of a procedure, flag that only section XXX was being performed.

{ ( WC62516 INTER-OFFICE MEMORANDUM __ e

' PROPER COMPLETION OF OPERATING PROCEP'.'RES Con't. OPS MEMO 2-79-01 Page 2 i L The above guidelines inconjunction with an effort to apply them, should eliminate this type of problem in the future along with any misunder-standings concerning partially completed procedures. J. R. Floyd Supervisor of Operations - Unit II JRF:je ec: B. L. Lutz G. P. Miller J. B. Logan C. A. Kunder M. J. Ross M. B. Bezilla

           .       Control Room Ops Memo Book - Unit II Ops Office Memo Book - Unit II f

s l f WC62517 O

The inspector noted the followino examples of imprcperly or inedequately completed c;.eratu g prv.edares:  !

           ' a.

OP 2102-1.3 (in progress on December 7, 1978) - Step ( *

           '             4.1.40 and subsequent steps were performed, but were not initialed as being ccmpleted;
           ; b.          OP 2102-3.2 (ccepleted September 23,,1978) - Steps 3.6,                                                   .
           !             3.7. 4.2.2 and 4.6.a were not initialed as being ccmpleted-                                               I

( i

           ' c. ,OP 2102-4.1 (partially completed February 17, 1978). All i

j prerecuisite steps were not initialed as being completed ' and Appendix A Valve Lineup was not fully ccmpleted;

d. OP 2103-1.1 (partially completed September 24, 1978) - i I

           )[           Section 3.1 step 8 Section 3.2 steps 10-35, 41-49 and .

51 and Section 4.2 steps 2 and 4 were not initialed as being ccmpleted; I

e. OP 2103-1.2 - Various procedural evolutions had been ]

performed, but no ccmpleted procedures were in the con-  : trol rocm files;

f. OP 2103-1.3 *(partia11y ccmpleted September 16, 1978) -

Steps 4.1.5.7 and 4.1.5.8 were perfor=ed, but were not initialed as being completed; 9 OP 2104-1.1 (partially ccmpleted August 22,1978) - Steps 3.1 and 3.2 were not initialed as being ccmpleted;

h. OP 2104-1.2 (ccepleted November 19, 1978) - Appendix A Valve Lineup was not fully ccmpleted; i.

OP 2104-1.4 (Appendix A . Valve Lineup completed July 14 j* 1978) - No prerequisite or startup procedure steps were r' initialed as being ccmpleted; j. OP 2104-6.2 (Undated) - Many steps were 'rict initialeT as being completed, and the partially ccmpleted procedure was not annotated with the date.of perfornance;

k. OP 2104-6.2 (portions ccmpleted on May 30 and December 8. -

1978) - Procedure excerpts for diesel generator manual

                     ' entire start evclutions precedure; were in the control reem files vice the

l. OP 2104-6.3 (Appendix A Valve Lineup completed November 17, 1978) - No prerequisite or startup procedure steps , ,

were initialed as being completed; , , ,

m. OP 2105-1.2 (partially ccmpleted August 25,1978) - Steps 4.4, 4.5.8(1)-(14) and 4.5.8(18)-(25) were not initialed as being completed;

n. OP 2105-1.3 (partially ccmpleted October 9,1978) - Sec-tion 4.2 steps were not initicled as being c:mpleted;

                      ""d'

( . WC625.13 c. OP 2l05-1.9 (Undated) - Steps 4.2.1.17, 4.2.1.18, 4.2.8.1, 4.2.8.2.1 and 4.2.8.2.2 were not initialed as being ccm-pleted and the partially ccmpleted precedure was not annotated with the date of performance. ' - " - - L -

s '. .

                                                                                                                       -.-.............-s                                  x The inspector stated that, based on the number of discre'pancies j                                noted above, corrscrive action was necessary to assure conformance with licensee administrative controls for operating procedure
    .(                          implementation and review. Licensee representatives stated that operators would be reminded of their responsibilities for proper procedure completion. This item is unresolved pending review of licensee corrective actions and selected, completed operating procedures during a subsequent inspection.                                                                           4 I-l(

s The 15spector noted the following examples of improperly annotating unused control room controlled file and/or working (320/78-36-3 1.) coptes of operating procedures: - *

a. OP 2102-3.2 - File and working copy steps 4.27.1 and 4.28 were initialed as being ccmpleted; i

b. QP 2102-4.1 - Several working copy prerequisite and purge procedure steps were initialed as being completed; and,

                                   ..      c.

1'

• OP 2103-1.2 - Working copy Page 36.0 was annotated with
• numbers.

The above file and working copies of operating procedures were stored in control rocm file cabinets for controlled use. These procedures should have no annotations, except references to effec-tive TCNs or cancelled TCNs. Licensee representatives stated that

                     '        a full page audit of file and working copies of control room pro-
                '             cedures was scheduled to be performed. In addition to page check-ing for procedure completeness, the pages will be reviewed for

(. improper annotations. This item is unresolved pending completion of the scheduled procedure audit. (320/78-35-02) pa.c n-Sp 2301-51 incorporates various Technical Specification sur ..

                                   . veillance requirements to be perfor=ed at once per shift, 12 hour or daily frequencies. The inspector noted the following examples of improperly implementing SP 2301-51:

a.. Boron reductions were made on 5 occasions ~ without com-pleting Appendix H, as required by 5P 2301-51;

• b,

{ performer and/or approver signatures were missing o'n " several. occasions;

c. Various parameters were not recorded or were incorrectly recorded on several occasions, including containment

   - - - -                  -               '     atmosphere and gaseous menitoring system channel checks, RPI/ API / group control rod positions, condensate storage -

tank level, operational mode, R.B. purge valve accumulated time, RPS channel check, source range flux, BWST temper-ature, R.B. pressure deviations and pump / flux contact

• monitors; and,

                                ;        d.       Unapproved minor changes were made to required data, i.e. '
                                                  "HR" to "WR", of SP 2301-51 on six occasions.

1

  -                         The inspector stated that except as described above, all portions of the SPs 2301-51 had been fully and properly completed. Licensee representatives stated that appropriate action would be taken to assure th t SP 2301-51 is preptrly impit.mented in the future. This
                  . .-- item is unresolved pending review of licensee corrective actions                                                                              - ' ~ " "

and selected completed SPs 2301-51 during a subsequent inspection. (320/78-36-03) , u .,,. ,. ... - - --. . . - - -

    "Y**      * * * * * *

     , 4,       .                         -
                                                               , ,                     -. ,,,    . .   . . g ,y,t . 4-   .- . ,,

LIST OT ETTECTIVE UNIT II OPERATIONS DEPT. MEMO Nr. Date Subject 2-78-1 12-23-77 Major Plow Path Valve Line-up 2-78-2 12-23-77 - Parameter Indication 2-78-3 12-22-77, , Shilt Turnover ,

                                    ~

2-78-4 1-9-78 Unit II Operations Department Memo

      .        2-78-5      1-31-78                Inservice Inspection Data                                            .
                                                                                                                                   )

2-78-7 2-6-78 . Control Building Area Bulkhead Dcors 2-78-8 2-6-78 Di'esel Generat'or Start Attempts / Transient Cycles Logbook Unit II 2-78-9 3-31-78 Containment Purge Supply & Exhaust isolation Valve Operation 2-78-10 5-10-78 Small Break iOCA Procedure Changes 2-7,8-12 6-3-78 TCN's To Station Procedures 2-78-16 8-31-78 Auxiliary Operator Logs 2-78-18 9-22-78 Tire Doors 2-78-20 11-6-78 Tault Recording Oscillograph 2-78-21 ,11-28-78 Relay Operation Reporting 2-78-22 11-28-78 Aux. Operators Logs 2-78-24 12-18-78 Guidance for the Performance of Valve Line-ups

                                            ~

2-78-25 12-18-78 Turbines On Turning Gear 2-79-01 1-25-79 Proper Completion Of Operating Procedures

?

O e

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